| NPI | 1548539323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L SWAIM Cota/L 262-598-9146 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 4806027) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |