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Organization
MANAWA COMMUNITY NURSING CENTER INC.
Active
Organization
MANAWA COMMUNITY NURSING CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL JOSEPH MATICEK SR. (OWNER)
(920) 596-2566
Entity
Organization
Contact information
Practice address
400 E 4TH ST, MANAWA, WI 54949
(920) 596-2566
(920) 596-2588
Mailing address
400 E 4TH ST, MANAWA, WI 54949-9227
(920) 596-2566
(920) 596-2588
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2616
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20105000
—
WI
Enumeration date
05/27/2005
Last updated
12/14/2009
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