| NPI | 1235474792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN PRINCE Administrator 920-683-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WI 20200900) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |