Healthcare Provider Details

I. General information

NPI: 1881486587
Provider Name (Legal Business Name): COUNTY OF GREEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N3150 STATE ROAD 81
MONROE WI
53566-9397
US

IV. Provider business mailing address

N3150 STATE ROAD 81
MONROE WI
53566-9397
US

V. Phone/Fax

Practice location:
  • Phone: 608-325-2171
  • Fax: 608-325-1352
Mailing address:
  • Phone: 608-325-2171
  • Fax: 608-325-1352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREA DENISE SWEENEY
Title or Position: DIRECTOR, FINANCE
Credential:
Phone: 608-328-9456