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Organization

COVENANT CARE LLC

Active
Other names
Fall Creek Valley Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN CHARLES HALBLEIB (ADMINISTRATOR)
(715) 877-2411
Entity
Organization

Contact information

Practice address
344 W LINCOLN AVE, FALL CREEK, WI 54742-9397
(715) 877-2411
(715) 877-2416
Mailing address
PO BOX 398, FALL CREEK, WI 54742-0398
(715) 877-2411
(715) 877-2416

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2073
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20190400
WI
Enumeration date
06/10/2005
Last updated
08/22/2020
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