| NPI | 1548337603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL FISCUS Administrator 262-478-1501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 5017) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |