Organization
FOND DU LAC COUNTY
Active
Other names
Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE T HANDRICH (ADMINISTRATOR)
(920) 929-3309
Entity
Organization
Contact information
Practice address
459 EAST FIRST STREET, FOND DU LAC, WI 54935-4505
(920) 929-3500
(920) 929-7046
Mailing address
459 EAST FIRST STREET, FOND DU LAC, WI 54935-4505
(920) 929-3500
(920) 929-7046
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2383
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20161200
—
WI
Enumeration date
02/21/2007
Last updated
10/01/2008
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