Organization
EVANSVILLE MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE MARTIN (ADMINISTRATIVE ASSISTANT)
(608) 882-5700
Entity
Organization
Contact information
Practice address
470 GARFIELD AVE, EVANSVILLE, WI 53536-1014
(608) 882-5700
(608) 882-0833
Mailing address
470 GARFIELD AVE, EVANSVILLE, WI 53536-1014
(608) 882-5700
(608) 882-0833
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2259
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20147800
—
WI
Enumeration date
10/04/2005
Last updated
08/22/2020
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