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General NPI Number Information
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NPI Number | 1275693178
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Entity Type | Organization
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Legal Business Name | COUNTY OF ROCK
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3530 N CTY TRK F
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City | JANESVILLE
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State | WI
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Zip | 53547-0726
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Country | US
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Telephone | 608-757-5152
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Fax | 608-757-5116
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Provider Business Mailing Address
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Address Line | 1717 CENTER AVE STE 420
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City | JANESVILLE
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State | WI
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Zip | 53546-2818
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Country | US
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Telephone | 608-757-5152
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Fax | 608-757-5116
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Authorized Official
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Title or Position | BUSINESS SUPERVISOR
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Name | MS. JILLIAN BAUER
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Credential |
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Telephone | 608-757-5152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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