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Organization

GRANCARE INC

Active
Other names
Grancare Nursing and Rehabilitation Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM L MACKENZIE (ADMINISTRATOR)
(920) 921-6800
Entity
Organization

Contact information

Practice address
517 E DIVISION ST, FOND DU LAC, WI 54935-3735
(920) 921-6800
(920) 921-6875
Mailing address
517 E DIVISION ST, FOND DU LAC, WI 54935-3735
(920) 921-6800
(920) 921-6875

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1044
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20193800
WI
Enumeration date
09/27/2005
Last updated
08/22/2020
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