Organization
WILLOWBROOK NURSING & REHAB CENTER
Active
Parent organization
EXTENDICARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
EXTENDICARE
Authorized official
ANN EVENSON SLP (FRC)
(920) 648-3144
Entity
Organization
Contact information
Practice address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
(920) 648-3144
(920) 648-3441
Mailing address
901 MULBERRY ST, LAKE MILLS, WI 53551-1335
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
11296024
WI
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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