| NPI | 1205985140 |
|---|---|
| Former Legal Business Name | THEDA CLARK MEDICAL CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | WILLIAM FLETT CFO 920-454-4013 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: WI 52T045) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2024-01-02 |