Organization
PRAIRIE NURSING FACILITY LLC
Active
Other names
Prairie Maison
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JO WOLCOTT (ADMINISTRATOR)
(608) 326-8471
Entity
Organization
Contact information
Practice address
700 S. FREMONT STREET, PRAIRIE DU CHIEN, WI 53821
(608) 326-8471
(608) 326-3205
Mailing address
700 S. FREMONT STREET, PRAIRIE DU CHIEN, WI 53821
(608) 326-8471
(608) 326-3205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3170
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20194200
—
WI
Enumeration date
06/01/2005
Last updated
07/22/2009
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