Healthcare Provider Details
I. General information
NPI: 1184798761
Provider Name (Legal Business Name): COUNTY OF IOWA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2006
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3151 COUNTY ROAD CH
DODGEVILLE WI
53533-9108
US
IV. Provider business mailing address
222 N IOWA ST
DODGEVILLE WI
53533-1540
US
V. Phone/Fax
- Phone: 608-935-3321
- Fax: 608-935-3962
- Phone: 608-935-0397
- Fax: 608-935-6024
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 2364 |
| License Number State | WI |
VIII. Authorized Official
Name: MS.
BARBARA
B
LINSCHEID
Title or Position: NURSING HOME ADMINISTRATOR
Credential: NHA
Phone: 608-935-3321