NPI | 1215981998 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY TAXDAHL Administrator 715-268-7107 |
Organization Subpart ? | Yes |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WI 2376) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2011-08-11 |