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Organization
THI OF WISCONSIN AT HARTFORD, LLC
Active
Organization
THI OF WISCONSIN AT HARTFORD, LLC
Active
Other names
The Pavilion at Glacier Valley
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA OHMAN (PRESIDENT)
(262) 297-6300
Entity
Organization
Contact information
Practice address
1900 AMERICAN EAGLE DR, SLINGER, WI 53086-9043
(262) 297-6300
(262) 297-6301
Mailing address
1900 AMERICAN EAGLE DR, SLINGER, WI 53086-9043
(262) 297-6300
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20191500
—
WI
Enumeration date
10/07/2006
Last updated
03/25/2020
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