Organization
COUNTY OF TREMPEALEAU
Active
Parent organization
COUNTY OF TREMPEALEAU
Other names
River Way South
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF TREMPEALEAU
Authorized official
MR. JERRY DEETZ N.H.A. (EXCECUTIVE DIRECTOR)
(715) 538-4312
Entity
Organization
Contact information
Practice address
39906 COMMERCIAL AVE, WHITEHALL, WI 54773-2603
(715) 983-5658
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
11602
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11602
ADULT FAMILY HOME
WI
Enumeration date
03/09/2007
Last updated
04/19/2021
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