Healthcare Provider Details

I. General information

NPI: 1013182757
Provider Name (Legal Business Name): MARQUETTE COUNTY DHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 UNDERWOOD AVE
MONTELLO WI
53949
US

IV. Provider business mailing address

428 UNDERWOOD AVE PO BOX 405
MONTELLO WI
53949
US

V. Phone/Fax

Practice location:
  • Phone: 608-297-3124
  • Fax: 608-297-8718
Mailing address:
  • Phone: 608-297-3124
  • Fax: 608-297-8718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROL WRIGHT
Title or Position: DIRECTOR
Credential:
Phone: 608-297-3124