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Organization
GOOD SHEPHERD HOME, LTD
Active
Organization
GOOD SHEPHERD HOME, LTD
Active
Other names
Good Shepherd Rehabilitation Agency
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH A CAPTAIN RN NHA (EXECUTIVE DIRECTOR)
(920) 833-6856
Entity
Organization
Contact information
Practice address
958 FOOTE STREET, SEYMOUR, WI 54165
(920) 833-7796
(920) 833-2220
Mailing address
958 FOOTE STREET, SEYMOUR, WI 54165
(920) 833-7796
(920) 833-2220
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2659
WI
225X00000X
Occupational Therapist
Primary
2659
WI
235Z00000X
Speech-Language Pathologist
2659
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41814400
—
WI
Enumeration date
03/08/2006
Last updated
01/12/2012
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