| NPI | 1609913904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY D ELLIS Executive Director 715-545-3984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2042154) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |