| NPI | 1336109776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN FARRAGH RN 920-450-8323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: WI 132453-030) |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WI 132453-030) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2025-09-11 |