NPI 1295783124

County of Trempealeau

Organisation Mental Illness Community Based Residential Treatment Facility Whitehall, WI

Practice location

Address: 18425 Dodge St, Whitehall, WI 54773-8444
Phone: (715) 538-4518
Fax: (715) 538-4535
Mailing address: W20410 State Road 121, Whitehall, WI 54773-9147

Authorised official

Name: Jerry Deetz
Title: Executive Director
Phone: (715) 538-4312

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence CBRF474 (WI)

Other Community Based Residential Treatment Facility, Mental Illness providers in Wisconsin →

Registry record

NPI: 1295783124
Entity type: Organization
NPI issued: 4 May 2006
Record last updated: 15 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.