| NPI | 1508015884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE AARON MATZ Cota 920-766-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 4606027) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |