| NPI | 1184040297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN JENKINS Registered Nurse 920-568-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric (Licence: WI 13443030) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |