| NPI | 1245209196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON MARIE BLOMDAHL Ventilator Nurse 414-525-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WI 33596031) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-08-22 |