| NPI | 1457312209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA L. WIRKUS Nursing Home Administrator 920-324-9051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 0525) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: WI 0010292) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-01-07 |