| NPI | 1316422025 |
|---|---|
| Doing Business As | EDENBROOK OF FOND DU LAC |
| Entity Type | Organization |
| Authorized Contact | PAMELA RICE Director Of Revenue 773-825-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2020-09-16 |