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COUNTY OF MONROE CLERK COURT

Intermediate Care Facility, Mentally Retarded

Sparta, Wisconsin

Provider NPI: 1942362108

Organization Information:
Organization Name:  COUNTY OF MONROE CLERK COURT


Practice Location:
14345 COUNTY HIGHWAY B  SPARTA, WI 54656 US
Tel: 608-269-8800  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
WI=========

Other Provider Identifiers:

IssuerNumberStateType
21052600WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS WI - Page 1



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