Organization
MANITOWOC HEALTH CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGEI SHVETZOFF (DIRECTOR)
(763) 537-5700
Entity
Organization
Contact information
Practice address
2021 S ALVERNO RD, MANITOWOC, WI 54220-9208
(920) 683-4100
Mailing address
12900 WHITEWATER DR STE 201, HOPKINS, MN 55343-9407
(763) 537-5700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2398
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20200900
—
WI
Enumeration date
06/10/2005
Last updated
11/06/2019
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