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Organization

WISCONSIN ILLINOIS SENIOR HOUSING, INC.

Active
Other names
Ingleside Manor
Organization subpart
No

Provider details

NPI number
Authorized official
MS. STEPHANIE SHERMAN (CHIEF OPERATION OFFICER)
(303) 980-0611
Entity
Organization

Contact information

Practice address
407 N 8TH ST, MOUNT HOREB, WI 53572-1872
(608) 437-5511
(608) 437-9603
Mailing address
407 N 8TH ST, MOUNT HOREB, WI 53572-1872
(608) 437-5511
(608) 437-9603

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2287
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518213222
WI
Enumeration date
07/31/2012
Last updated
10/13/2021
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