| NPI | 1093799272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJORIE GOZDOWIAK Administrator COO 262-387-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 235) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: WI 1999) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2025-09-11 |