Organization
SHELL LAKE SNF LLC
Active
Other names
Shell Lake Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON WILLIAM HANSEN (CEO)
(320) 828-7310
Entity
Organization
Contact information
Practice address
802 E CTY HWY B, SHELL LAKE, WI 54871
(715) 468-4292
(715) 468-4232
Mailing address
PO BOX 642, SAUK RAPIDS, MN 56379-0642
(320) 828-7310
(320) 764-2665
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2748
WI
314000000X
Skilled Nursing Facility
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2748
BUSINESS LICENSE NUMBER
WI
Enumeration date
06/14/2007
Last updated
08/18/2025
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