Organization
DODGE COUNTY MEDICAL FACILITIES
Active
Other names
Dodge County Facility Physician Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE E HOOPER NHA RN (ADMINISTRATOR)
(920) 386-3409
Entity
Organization
Contact information
Practice address
199 HOME RD, JUNEAU, WI 53039-1401
(920) 386-3400
(920) 386-3800
Mailing address
199 HOME RD, JUNEAU, WI 53039-1401
(920) 386-3400
(920) 386-3800
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32823200
—
WI
Enumeration date
05/25/2007
Last updated
05/21/2009
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