Organization
THEDACARE, INCORPORATED
Active
Other names
Peabody Manor
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
2600 S HERITAGE WOODS DR, APPLETON, WI 54915-1408
(920) 738-3000
(920) 225-7791
Mailing address
2600 S HERITAGE WOODS DR, APPLETON, WI 54915-1408
(920) 738-3000
(920) 225-7791
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2622
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20188400
—
WI
Enumeration date
07/05/2006
Last updated
01/02/2024
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