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Organization

LOUISE B., LLC.

Active
Other names
Glencare Rehab & Living Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA RENE ROTH (CONTROLLER)
(317) 557-1190
Entity
Organization

Contact information

Practice address
1633 W BENDER RD, GLENDALE, WI 53209-3801
(312) 705-2000
(317) 245-2510
Mailing address
1633 W BENDER RD, GLENDALE, WI 53209-3801
(312) 705-2000
(317) 245-2510

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3185
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20182800
WI
Enumeration date
02/11/2009
Last updated
02/11/2009
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