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Organization
DALLAS HEALTHCARE CENTER INC.
Active
Organization
DALLAS HEALTHCARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEN F FAST (ADMINISTRATOR)
(715) 837-1222
Entity
Organization
Contact information
Practice address
104 E DALLAS ST, DALLAS, WI 54733-9699
(715) 837-1222
(715) 837-1713
Mailing address
104 E DALLAS ST, P.O. BOX 220, DALLAS, WI 54733-9699
(715) 837-1222
(715) 837-1713
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20167500
—
WI
Enumeration date
01/15/2007
Last updated
07/11/2007
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