Organization
BLACK RIVER MEMORIAL HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH WHITE-JACOBS RN BSN MHA FACHE (PRESIDENT & CEO)
(715) 284-5361
Entity
Organization
Contact information
Practice address
311 COUNTY ROAD A STE 1, BLACK RIVER FALLS, WI 54615-8205
(715) 284-5361
(715) 284-1398
Mailing address
711 W ADAMS ST, BLACK RIVER FALLS, WI 54615-9108
(715) 284-5361
(715) 284-1398
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
527298
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41538200
—
WI
Enumeration date
01/08/2007
Last updated
12/16/2016
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