| NPI | 1336340561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAHRA S MOHAMED Lpn 608-279-7974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WI 305671-031) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2020-08-22 |