# SHEBOYGAN SENIOR COMMUNITY, INC.

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

## Provider details

- **NPI number:** 1831197425
- **Authorized official:** JOAN KLEIST RN, HNA (ADMINISTRATOR)
- **Authorized official phone:** (920) 458-2137

## Contact information

- **Practice address:** 3505 CTY RD. Y, SHEBOYGAN, WI 53083-2400
- **Practice address phone:** (920) 458-2137
- **Practice address fax:** (920) 458-5922
- **Mailing address:** 3505 CTY RD. Y, SHEBOYGAN, WI 53083-2400
- **Mailing address phone:** (920) 458-2137
- **Mailing address fax:** (920) 458-5922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2662 | WI | Yes |

## Other

- **Enumeration date:** 07/08/2005
- **Last updated:** 11/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 20158600 | — | WI |