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Organization

COUNTY OF TREMPEALEAU

Active
Parent organization
COUNTY OF TREMPEALEAU
Other names
River Way North
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
W21011 STATE ROAD 121, INDEPENDENCE, WI 54747
(715) 985-3673
Mailing address
W20410 STATE ROAD 121, WHITEHALL, WI 54773-9147
(715) 538-4312
(715) 538-2426

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
11601
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11601
ADULT FAMILY HOME
WI
Enumeration date
03/09/2007
Last updated
04/15/2021
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