| NPI | 1740270735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE K EIDSOR Business Manager 262-925-8104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2332) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2011-08-11 |