Organization
SANTA MARIA NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELEN DESOTELL NHA (ADMINISTRATOR)
(920) 432-5231
Entity
Organization
Contact information
Practice address
430 S CLAY ST, GREEN BAY, WI 54301-3807
(920) 432-5231
(920) 432-9881
Mailing address
430 S CLAY ST, GREEN BAY, WI 54301-3807
(920) 432-5231
(920) 432-9881
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1134
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134
LICENSE NUMBER
WI
05
—
20152400
—
WI
Enumeration date
09/26/2005
Last updated
08/22/2020
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