Organization
SNH WIS TENANT LLC
Active
Parent organization
SNH WIS TENANT LLC
Other names
Virginia Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SNH WIS TENANT LLC
Authorized official
JENNIFER F. MINTZER (PRESIDENT & CHIEF OPERATING OFFICER)
(617) 796-8350
Entity
Organization
Contact information
Practice address
1451 CLEVELAND AVE, WAUKESHA, WI 53186-3876
(262) 547-2123
(262) 547-6204
Mailing address
255 WASHINGTON ST STE 300, NEWTON, MA 02458-1634
(617) 796-8350
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WI
Enumeration date
09/13/2019
Last updated
05/07/2020
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