Organization
COUNTY OF TREMPEALEAU
Active
Parent organization
COUNTY OF TREMPEALEAU
Other names
TCHCC IMD
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF TREMPEALEAU
Authorized official
JERRY DEETZ N.H.A. (EXECUTIVE DIRECTOR)
(715) 538-4312
Entity
Organization
Contact information
Practice address
W20410 STATE ROAD 121, WHITEHALL, WI 54773-9147
(715) 538-4312
(715) 538-2426
Mailing address
W20410 STATE ROAD 121, WHITEHALL, WI 54773-9147
(715) 538-4312
(715) 538-2426
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
5001
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P290
IMD FACILITY
WI
Enumeration date
05/03/2006
Last updated
04/15/2021
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