Organization
COUNTY OF SHAWANO
Active
Other names
Maple Lane Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBRA R KESSEN (ACCOUNTANT/CONTROLLER)
(715) 526-3158
Entity
Organization
Contact information
Practice address
N4231 STATE HIGHWAY 22, SHAWANO, WI 54166-6130
(715) 526-3158
(715) 526-6823
Mailing address
N4231 STATE HIGHWAY 22, SHAWANO, WI 54166-6130
(715) 526-3158
(715) 526-6823
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2579
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20160600
—
WI
Enumeration date
07/28/2005
Last updated
09/10/2007
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