Organization
KELLY'S CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WILBURN L.P.N. (OWNER)
(262) 977-5832
Entity
Organization
Contact information
Practice address
713 MAPLE ST, TWIN LAKES, WI 53181-9542
(262) 977-5832
Mailing address
713 MAPLE ST, TWIN LAKES, WI 53181-9542
(262) 977-5832
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
311416-031
WI
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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