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Organization
PRAIRIE NURSING FACILITY LLC
Active
Organization
PRAIRIE NURSING FACILITY LLC
Active
Other names
Prairie Maison
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JO WOLCOTT (ADMINISTRATOR)
(608) 326-8471
Entity
Organization
Contact information
Practice address
700 S. FREMONT STREET, PRAIRIE DU CHIEN, WI 53821
(608) 326-8471
(608) 326-3205
Mailing address
700 S. FREMONT STREET, PRAIRIE DU CHIEN, WI 53821
(608) 326-8471
(608) 326-3205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3170
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20194200
—
WI
Enumeration date
06/01/2005
Last updated
07/22/2009
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