Organization
COUNTY OF SHEBOYGAN
Active
Other names
Rocky Knoll Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J TAUBENHEIM N.H.A. (ADMINISTRATOR)
(920) 893-9205
Entity
Organization
Contact information
Practice address
N7135 ROCKY KNOLL PKWY, PLYMOUTH, WI 53073-3103
(920) 467-6464
(920) 893-0500
Mailing address
N7135 ROCKY KNOLL PKWY, PLYMOUTH, WI 53073-3103
(920) 467-6464
(920) 893-0500
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2362
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20141300
—
WI
01
—
32670800
PHYSICIAN MEDICAID
WI
05
—
41666800
—
WI
Enumeration date
11/14/2006
Last updated
02/07/2008
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