| NPI | 1093786543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HERMAN CFO 920-766-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2988) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2021-02-26 |