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Organization

ODD FELLOW REBEKAH HOME ASSOCIATION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAN-A J KOHN NHA (CEO)
(920) 593-1640
Entity
Organization

Contact information

Practice address
1207 S JACKSON ST, GREEN BAY, WI 54301-3037
(920) 593-1640
(920) 435-5031
Mailing address
1207 S JACKSON ST, GREEN BAY, WI 54301-3037
(920) 593-1640
(920) 435-5031

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2544
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20151600
WI
Enumeration date
01/04/2006
Last updated
01/13/2026
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