| NPI | 1629106570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA J ANHALT Office Manager 920-898-4296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2366) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |