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General NPI Number Information
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NPI Number | 1356953475
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Entity Type | Organization
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Legal Business Name | COUNTY OF TREMPEALEAU
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | N36655 COUNTY ROAD QQQ
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City | WHITEHALL
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State | WI
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Zip | 54773-4401
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Country | US
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Telephone | 715-538-9137
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Fax | 715-538-9133
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Provider Business Mailing Address
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Address Line | W20410 STATE ROAD 121
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City | WHITEHALL
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State | WI
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Zip | 54773-9147
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Country | US
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Telephone | 715-538-4312
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Fax | 715-538-2426
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | LORI GLAUNERT
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Credential |
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Telephone | 715-538-4312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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