Organization · Type 2 NPI

County of Trempealeau

Mental Illness Community Based Residential Treatment Facility · Whitehall, WI

NPI number 1295783124 Active

Practice location

18425 Dodge St
Whitehall, WI 54773-8444

Call (715) 538-4518 Map

Fax (715) 538-4535

Mailing address

W20410 State Road 121
Whitehall, WI 54773-9147

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	CBRF474 (WI)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Other mental illness community based residential treatment facility providers in Whitehall

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NPI record

NPI: 1295783124
Entity type: Organization (Type 2)
Issued: May 4, 2006
Last updated: Apr 15, 2021
Status: Active
Subpart: Yes of County of Trempealeau

Other names

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Tchcc Farnam · doing business as
Tchcc Farnam · doing business as

Authorized official

Jerry Deetz, N.H.A.
Executive Director
(715) 538-4312

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1295783124

County of Trempealeau's National Provider Identifier is 1295783124, issued on May 4, 2006. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Whitehall, WI. The record was last updated on Apr 15, 2021.