| NPI | 1356303101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTE PONDER Lpn Rcs 414-447-1489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: WI 11818) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-08-22 |