Organization
NORTH OAK HEALTH CARE WISTERIA HAUS LLC
Active
Other names
Wisteria Haus
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEAN CARL MASCHOFF (MEMBER)
(847) 612-0750
Entity
Organization
Contact information
Practice address
2741 45TH ST, TWO RIVERS, WI 54241-1002
(847) 612-0750
(920) 794-4057
Mailing address
1025 SHERMER RD, NORTHBROOK, IL 60062-3730
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0016823
WI
Other
Enumeration date
09/26/2017
Last updated
08/14/2020
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