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Organization
LSS OF SHEBOYGAN, LLC
Active
Organization
LSS OF SHEBOYGAN, LLC
Active
Other names
Sunny Ridge Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNE STARK (ADMINISTRATOR)
(920) 459-3028
Entity
Organization
Contact information
Practice address
3014 ERIE AVE, SHEBOYGAN, WI 53081-3658
(920) 459-3028
(920) 459-4341
Mailing address
3014 ERIE AVENUE, SHEBOYGAN, WI 53081
(920) 459-3028
(920) 459-4341
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2363
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20198500
—
WI
Enumeration date
11/14/2006
Last updated
07/17/2007
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