Provider Demographics
NPI:1952306748
Name:COUNTY OF MONROE
Entity Type:Organization
Organization Name:COUNTY OF MONROE
Other - Org Name:ROLLING HILLS REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:GARLYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROOKSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-269-8818
Mailing Address - Street 1:14400 COUNTY HIGHWAY B
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-4611
Mailing Address - Country:US
Mailing Address - Phone:608-269-8800
Mailing Address - Fax:608-269-4386
Practice Address - Street 1:14400 COUNTY HIGHWAY B
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-4611
Practice Address - Country:US
Practice Address - Phone:608-269-8800
Practice Address - Fax:608-269-4386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2379314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20128500Medicaid
WI525430Medicare ID - Type UnspecifiedPROVIDER NUMBER