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General NPI Number Information
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NPI Number | 1295849784
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH'S COMMUNITY HEALTH SERVICES, INC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 400 WATER AVENUE
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City | HILLSBORO
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State | WI
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Zip | 54634
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Country | US
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Telephone | 608-489-8000
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Fax | 608-489-8181
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Provider Business Mailing Address
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Address Line | PO BOX 527
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City | HILLSBORO
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State | WI
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Zip | 54634-0527
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Country | US
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Telephone | 608-489-8000
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Fax | 608-489-8181
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. DEBRA S. SMITH
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Credential |
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Telephone | 608-489-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2186
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License Number State | WI
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