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Organization

SUN PRAIRIE HEALTH CARE CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWIN M. KRUCHTEN (OWNER)
(608) 849-5016
Entity
Organization

Contact information

Practice address
228 W MAIN ST, SUN PRAIRIE, WI 53590-2908
(608) 251-1171
(608) 825-4390
Mailing address
228 W MAIN ST, SUN PRAIRIE, WI 53590-2908
(608) 251-1171
(608) 825-4390

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2598
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20186100
WI
Enumeration date
10/12/2005
Last updated
01/31/2008
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