| NPI | 1801968847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE STARK Administrator 920-459-3028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 2363) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-17 |