Organization
MARYHILL MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARRIE LYNN KALDOR (BUSINESS OFFICE MANAGER)
(715) 251-3172
Entity
Organization
Contact information
Practice address
501 MADISON AVENUE, NIAGARA, WI 54151
(715) 251-3172
(715) 251-1200
Mailing address
501 MADISON AVENUE, NIAGARA, WI 54151
(715) 251-3172
(715) 251-1200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2964
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20005000
—
WI
Enumeration date
06/13/2005
Last updated
08/22/2020
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