| NPI | 1992911796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANKER Cota 920-842-2191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WI 1530-027) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |