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Organization
GRAVES ENTERPRISES INC D/B/A OREGON MANOR
Active
Organization
GRAVES ENTERPRISES INC D/B/A OREGON MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L GRAVES LNHA (PRESIDENT)
(608) 835-3535
Entity
Organization
Contact information
Practice address
354 N MAIN ST, OREGON, WI 53575-1426
(608) 835-3535
(608) 835-3890
Mailing address
354 N MAIN ST, OREGON, WI 53575-1426
(608) 835-3535
(608) 835-3890
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
20100100
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114001666
NPI
WI
05
—
20100100
—
WI
Enumeration date
04/15/2013
Last updated
12/12/2013
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