# GRANCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grancare Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295721991
- **Authorized official:** MR. WILLIAM L MACKENZIE (ADMINISTRATOR)
- **Authorized official phone:** (920) 921-6800

## Contact information

- **Practice address:** 517 E DIVISION ST, FOND DU LAC, WI 54935-3735
- **Practice address phone:** (920) 921-6800
- **Practice address fax:** (920) 921-6875
- **Mailing address:** 517 E DIVISION ST, FOND DU LAC, WI 54935-3735
- **Mailing address phone:** (920) 921-6800
- **Mailing address fax:** (920) 921-6875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1044 | WI | Yes |

## Other

- **Enumeration date:** 09/27/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 20193800 | — | WI |