Organization
MASONIC CENTER FOR HEALTH AND REHAB INC.
Active
Other names
Masonic Healthcare Center Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN M FREUCK CFO (CHIEF FINANCIAL OFFICER)
(262) 965-7203
Entity
Organization
Contact information
Practice address
400 N MAIN ST, DOUSMAN, WI 53118-9348
(262) 965-2111
(262) 965-4053
Mailing address
410 N MAIN ST, DOUSMAN, WI 53118-9348
(262) 965-2111
(262) 965-5553
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2869
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20118900
—
WI
Enumeration date
07/30/2006
Last updated
03/15/2017
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