Organization
DYCORA TRANSITIONAL HEALTH - GREENDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HAWKINS (EXECUTIVE)
(414) 421-0088
Entity
Organization
Contact information
Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Mailing address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3142
WI
Other
Enumeration date
10/25/2016
Last updated
01/25/2018
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