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Organization
PARK MANOR, LTD.
Active
Organization
PARK MANOR, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON SCHULTZ (PRESIDENT)
(715) 762-2449
Entity
Organization
Contact information
Practice address
250 LAWRENCE AVE, PARK FALLS, WI 54552-1431
(715) 762-2449
(715) 762-3321
Mailing address
250 LAWRENCE AVE, PARK FALLS, WI 54552-1431
(715) 762-2449
(715) 762-3321
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
2452
WI
332BN1400X
Nursing Facility Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20145000
—
WI
05
—
41224900
—
WI
Enumeration date
10/04/2005
Last updated
07/28/2019
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