Organization
ORION FREDERIC LLC
Active
Other names
Frederic Nursing and Rehabilitation Community
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
(614) 416-0600
Entity
Organization
Contact information
Practice address
205 UNITED WAY, FREDERIC, WI 54837-8938
(715) 327-4297
Mailing address
5000 HAKES DR, SUITE 600, NORTON SHORES, MI 49441-5574
(231) 799-6870
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3086
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20200400
—
WI
01
—
800059155019
BCBS PROVIDER CODE
WI
Enumeration date
01/31/2008
Last updated
02/13/2014
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