Organization
ARIZCONSIN GROUP INC
Active
Other names
Crandon Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA I RAU (ADMINISTRATOR)
(715) 478-3324
Entity
Organization
Contact information
Practice address
105 W PIONEER ST, CRANDON, WI 54520-1554
(715) 478-3324
(715) 478-5085
Mailing address
PO BOX 400, CRANDON, WI 54520-0400
(715) 478-3324
(715) 478-5085
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2945
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20124900
—
WI
01
—
2945
FACIOLITY LICENSE NUMBER
WI
Enumeration date
07/29/2005
Last updated
08/08/2007
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