Organization
ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS D. TROST (CEO/ADMINISTRATOR)
(920) 926-6068
Entity
Organization
Contact information
Practice address
33 EVERETT ST, FOND DU LAC, WI 54935
(920) 926-7980
(920) 923-7995
Mailing address
33 EVERETT ST, FOND DU LAC, WI 54935-4318
(920) 923-7980
(920) 923-7995
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
10373
WI
314000000X
Skilled Nursing Facility
Primary
2561
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20158100
—
WI
Enumeration date
10/19/2005
Last updated
08/23/2018
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