| NPI | 1093701088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAHN B BRADLEY Administrator 715-286-2266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2083) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2013-06-13 |