| NPI | 1376530626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER CHANG Administrator 262-334-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI p270) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2020-08-22 |