| 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 |