| NPI | 1851749576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI GULLICKSON Dor 920-731-7310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 1402-27) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |