Organization
WOODLANDS OF OCONTO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY DUFEK (ADMINISTRATOR)
(920) 834-4575
Entity
Organization
Contact information
Practice address
101 1ST ST, OCONTO, WI 54153-1117
(920) 834-4575
(920) 834-2537
Mailing address
430 MANOR DR, SURING, WI 54174-9182
(920) 842-1111
(920) 842-1153
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5009
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20191900
—
WI
Enumeration date
06/24/2005
Last updated
11/04/2011
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