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Organization

COUNTY OF TREMPEALEAU

Active
Parent organization
COUNTY OF TREMPEALEAU
Other names
TCHCC-ICFMR
Organization subpart
Yes

Provider details

NPI number
Legal business name
COUNTY OF TREMPEALEAU
Authorized official
MR. PHILLIP JOHN BORRESON N.H.A., M.S. (EXECUTIVE DIRECTOR)
(715) 538-4312
Entity
Organization

Contact information

Practice address
W20298 STATE ROAD 121, WHITEHALL, WI 54773-9685
(715) 538-4312
(715) 538-2426
Mailing address
W20298 STATE ROAD 121, WHITEHALL, WI 54773-9685
(715) 538-4312
(715) 538-2426

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2987
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21050700
WI
Enumeration date
05/03/2006
Last updated
06/04/2010
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