NPI | 1083937759 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL T FALE Registered Nurse 920-915-1499 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WI 159500-30) |
Enumeration Date | 2010-03-09 |
Last Update Date | 2010-03-09 |