Provider Demographics
NPI:1558710731
Name:TREMPEALEAU COUNTY HEALTH CARE CENTER
Entity Type:Organization
Organization Name:TREMPEALEAU COUNTY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:JASKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:715-985-2337
Mailing Address - Street 1:W20298 STATE ROAD 121
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:WI
Mailing Address - Zip Code:54773-9685
Mailing Address - Country:US
Mailing Address - Phone:715-985-2337
Mailing Address - Fax:715-538-2426
Practice Address - Street 1:W20298 STATE ROAD 121
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:WI
Practice Address - Zip Code:54773-9685
Practice Address - Country:US
Practice Address - Phone:715-985-2337
Practice Address - Fax:715-538-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1753343104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI175334OtherREGISTERED NURSE