| NPI | 1891961512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELDA EDITH MARTINEZ Occupational Therapy Assistant 920-725-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |