| NPI | 1023367612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE MAE SIMMONS Register Nursing 414-510-4893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WI 167452) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |