Organization
BROOKSIDE CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA HARDT NHA RN (ADMINISTRATOR)
(262) 653-3800
Entity
Organization
Contact information
Practice address
3506 WASHINGTON RD, KENOSHA, WI 53144
(262) 653-3800
(262) 653-3850
Mailing address
3506 WASHINGTON RD, KENOSHA, WI 53144
(262) 653-3800
(262) 653-3850
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3155
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20130300
—
WI
Enumeration date
05/03/2006
Last updated
02/05/2008
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