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Organization
MASONIC CENTER FOR HEALTH AND REHAB INC.
Active
Organization
MASONIC CENTER FOR HEALTH AND REHAB INC.
Active
Other names
Masonic Healthcare Center Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN M FREUCK CFO (CHIEF FINANCIAL OFFICER)
(262) 965-7203
Entity
Organization
Contact information
Practice address
400 N MAIN ST, DOUSMAN, WI 53118-9348
(262) 965-2111
(262) 965-4053
Mailing address
410 N MAIN ST, DOUSMAN, WI 53118-9348
(262) 965-2111
(262) 965-5553
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2869
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20118900
—
WI
Enumeration date
07/30/2006
Last updated
03/15/2017
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