Organization
WISCONSIN ILLINOIS SENIOR HOUSING INC.
Active
Other names
Geneva Lake Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE L. SHERMAN (MEDICARE PROGRAM MONITOR)
(303) 980-0611
Entity
Organization
Contact information
Practice address
211 S CURTIS ST, LAKE GENEVA, WI 53147-2052
(262) 248-3145
(262) 248-3564
Mailing address
211 S CURTIS ST, LAKE GENEVA, WI 53147-2052
(262) 248-3145
(262) 248-3564
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2693
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20184200
—
WI
Enumeration date
08/10/2005
Last updated
05/13/2020
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