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Organization
CCC OF EAST GREEN BAY
Active
Organization
CCC OF EAST GREEN BAY
Active
Other names
Crossroads Care Center of East Green Bay
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L MERZEL (CFO)
(847) 983-4860
Entity
Organization
Contact information
Practice address
600 S WEBSTER AVE, GREEN BAY, WI 54301-3503
(920) 432-3213
Mailing address
8150 CENTRAL PARK AVE, SKOKIE, IL 60076-2974
(847) 983-4860
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
WI
Enumeration date
07/18/2018
Last updated
03/29/2019
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