Organization
MCCARTHY NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JAMES MCCARTHY N.H.A (OWNER)
(608) 873-7462
Entity
Organization
Contact information
Practice address
124 S MONROE ST, STOUGHTON, WI 53589-2012
(608) 873-7462
(608) 873-9162
Mailing address
124 S MONROE ST, STOUGHTON, WI 53589-2012
(608) 873-7462
(608) 873-9162
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2689
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20006200
—
WI
Enumeration date
04/20/2007
Last updated
08/22/2020
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