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General NPI Number Information
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NPI Number | 1184761231
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Entity Type | Organization
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Legal Business Name | STOUGHTON HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 900 RIDGE ST
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City | STOUGHTON
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State | WI
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Zip | 53589-1864
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Country | US
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Telephone | 608-873-6611
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Fax | 608-873-2255
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Provider Business Mailing Address
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Address Line | 900 RIDGE ST
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City | STOUGHTON
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State | WI
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Zip | 53589-1864
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Country | US
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Telephone | 608-873-6611
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Fax | 608-873-2255
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL C DEGROOT
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Credential |
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Telephone | 608-873-2250
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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 |
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License Number State | WI
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