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General NPI Number Information
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NPI Number | 1043375876
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Entity Type | Organization
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Legal Business Name | LAFAYETTE COUNTY
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 729 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-0118
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Country | US
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Telephone | 608-776-4895
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Fax | 608-776-4885
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Provider Business Mailing Address
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Address Line | 729 CLAY ST P.O. BOX 118
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City | DARLINGTON
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State | WI
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Zip | 53530-0118
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Country | US
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Telephone | 608-776-4895
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Fax | 608-776-4885
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Authorized Official
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Title or Position | DIRECTOR
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Name | DEBBIE SIEGENTHALER
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Credential | RN, MSN
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Telephone | 608-776-4895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 68
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License Number State | WI
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