Healthcare Provider Details

I. General information

NPI: 1518127000
Provider Name (Legal Business Name): TREMPEALEAU COUNTY HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36125 E END RD
INDEPENDENCE WI
54747-8080
US

IV. Provider business mailing address

W20410 STATE ROAD 121
WHITEHALL WI
54773-9147
US

V. Phone/Fax

Practice location:
  • Phone: 715-985-2270
  • Fax: 715-985-2318
Mailing address:
  • Phone: 751-538-4312
  • Fax: 715-538-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number0012375
License Number StateWI

VIII. Authorized Official

Name: JERRY DEETZ
Title or Position: EXECUTIVE DIRECTOR
Credential: NHA
Phone: 715-538-4312