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Organization
CRYSTAL FOUNTAINS REHABILITATION CENTER LLC
Active
Organization
CRYSTAL FOUNTAINS REHABILITATION CENTER LLC
Active
Other names
Ledgeview Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE TRZEBIATOWSKI RN (DIRECTOR OF OPERATIONS)
(715) 340-1479
Entity
Organization
Contact information
Practice address
3737 DICKINSON RD, DE PERE, WI 54115-8797
(920) 336-7733
(920) 336-3697
Mailing address
3450 BRIDLEWOOD DR, PLOVER, WI 54467-3892
(715) 342-9100
(715) 342-9101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3105
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20171900
—
WI
Enumeration date
12/21/2015
Last updated
12/21/2015
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