Active NPI
Deer Dale Healthcare LLC
- Skilled Nursing Facility
- Mount Horeb, WI
National Provider Identifier
1336057363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- DEER DALE HEALTHCARE LLC
- Practice address
- 407 N 8TH St
Mount Horeb, WI 53572-1872 - Phone
- (608) 437-5511
- Fax
- (608) 470-4065
- NPI assigned
- Aug 31, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Soon Burnam
- Title
- Secretary
- Phone
- (949) 540-1249
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
407 N 8TH St
Mount Horeb, WI 53572-1872
Mailing address
407 N 8TH St
Mount Horeb, WI 53572-1872
Phone (608) 437-5511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788134400000",
"number": "1336057363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 N 8TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535721872",
"telephone_number": "608-437-5511",
"fax_number": "608-470-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 N 8TH ST",
"city": "MOUNT HOREB",
"state": "WI",
"postal_code": "535721872",
"telephone_number": "608-437-5511",
"fax_number": "608-470-4065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DEER DALE HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-31",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A",
"authorized_official_last_name": "BURNAM",
"authorized_official_first_name": "SOON",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "949-540-1249"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Horeb, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.