Organization
CEDAR CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY MARTIN (PROGRAM DIRECTOR)
(608) 373-6322
Entity
Organization
Contact information
Practice address
1072 S RIVER ROAD, JANESVILLE, WI 53546-5648
(608) 373-6322
Mailing address
1072 S RIVER ROAD, JANESVILLE, WI 53546
(608) 373-6322
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
182-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22
—
WI
Enumeration date
11/14/2013
Last updated
11/14/2013
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