| NPI | 1114923935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS FERGER Administrator 414-546-7330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2724) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2020-08-22 |