Organization
KINDRED TRANSITIONAL CARE REHABILITATION COLONIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE L BORCHARDT (OCCUPATIONAL THERAPIST)
(715) 573-2884
Entity
Organization
Contact information
Practice address
1010 E WAUSAU AVE, WAUSAU, WI 54403-3101
(715) 842-2028
Mailing address
1010 E WAUSAU AVE, WAUSAU, WI 54403-3101
(715) 842-2028
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5060-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
525405
MEDICARE
WI
Enumeration date
11/09/2011
Last updated
11/09/2011
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