| NPI | 1295803971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE NOVITZKE Administrator 715-762-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: WI 00-0000) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |