Organization
COUNTY OF WAUPACA
Active
Other names
Lakeview Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN M FEIRTAG (NURSING HOME ADMINISTRATOR)
(920) 867-2183
Entity
Organization
Contact information
Practice address
912 MANOR DR, WEYAUWEGA, WI 54983-8677
(920) 867-2183
(920) 867-2153
Mailing address
912 MANOR DR, WEYAUWEGA, WI 54983-8677
(920) 867-2183
(920) 867-2153
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2541
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20161300
—
WI
01
—
52A297
FEDERAL MEDICAID
WI
Enumeration date
09/14/2005
Last updated
02/20/2015
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