Organization
KIWANIS MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN SENECAL (ADMINISTRATOR)
(262) 642-3995
Entity
Organization
Contact information
Practice address
3271 NORTH ST, EAST TROY, WI 53120-1147
(262) 642-3995
(262) 642-3930
Mailing address
3271 NORTH ST, EAST TROY, WI 53120-1147
(262) 642-3995
(262) 642-3930
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2548
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20101100
—
WI
Enumeration date
07/07/2005
Last updated
08/22/2020
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