Provider Demographics
NPI:1992570998
Name:COUNTY OF ROCK
Entity type:Organization
Organization Name:COUNTY OF ROCK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-757-5152
Mailing Address - Street 1:1717 CENTER AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-2800
Mailing Address - Country:US
Mailing Address - Phone:608-757-5200
Mailing Address - Fax:
Practice Address - Street 1:1717 CENTER AVE STE 420
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2800
Practice Address - Country:US
Practice Address - Phone:608-757-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ROCK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-20
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health