Organization
LEDGE VIEW NURSING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD J DESOTELL (ADMINISTRATOR)
(920) 336-7733
Entity
Organization
Contact information
Practice address
3737 DICKINSON RD, DE PERE, WI 54115-8797
(920) 336-7733
(920) 339-7885
Mailing address
3737 DICKINSON RD, DE PERE, WI 54115-8797
(920) 336-7733
(920) 339-7885
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3105
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20171900
—
WI
Enumeration date
10/10/2005
Last updated
08/22/2020
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