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COUNTY OF TREMPEALEAU

Adult Care Home

Independence, Wisconsin

Provider NPI: 1790817641

Organization Information:
Organization Name:  COUNTY OF TREMPEALEAU


Practice Location:
W21011 STATE ROAD 121  INDEPENDENCE, WI 54747 US
Tel: 715-985-3673  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
WI11601

Other Provider Identifiers:

IssuerNumberStateType
ADULT FAMILY HOME11601WI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS WI - Page 1



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