| NPI | 1548404791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAELAN CLEONE PIEPER Cota 262-523-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 1997-27) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |