| NPI | 1750915575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA GIBNEY Executive Director Long Term Care & 608-612-0643 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-02 |