# SANTA MARIA NURSING HOME, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578559456
- **Authorized official:** MRS. HELEN DESOTELL NHA (ADMINISTRATOR)
- **Authorized official phone:** (920) 432-5231

## Contact information

- **Practice address:** 430 S CLAY ST, GREEN BAY, WI 54301-3807
- **Practice address phone:** (920) 432-5231
- **Practice address fax:** (920) 432-9881
- **Mailing address:** 430 S CLAY ST, GREEN BAY, WI 54301-3807
- **Mailing address phone:** (920) 432-5231
- **Mailing address fax:** (920) 432-9881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1134 | WI | Yes |

## Other

- **Enumeration date:** 09/26/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1134 | LICENSE NUMBER | WI |
| 05 | — | 20152400 | — | WI |