Organization
STATE OF WISCONSIN
Active
Other names
WI Veterans Home Union Grove
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY L SERVATIUS (HOMES DIVISION ADMINISTRATOR)
(715) 258-4251
Entity
Organization
Contact information
Practice address
21425G SPRING ST, UNION GROVE, WI 53182-9707
(262) 838-6700
(262) 878-6758
Mailing address
21425G SPRING ST, UNION GROVE, WI 53182-9707
(262) 838-6700
(262) 878-6758
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20197800
—
WI
Enumeration date
03/19/2007
Last updated
01/06/2026
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