| NPI | 1578612081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORISLAV KRESOVIC Administrator 414-282-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2230) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2012-02-09 |