| NPI | 1063797561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN PATRICIA SORENSON Cota 920-459-3028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 4854-27) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |