Organization
COUNTY OF OUTAGAMIE
Active
Other names
Brewster Village
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A ROTHMANN NHM ADMINISTRATOR (ADMINISTRATOR)
(920) 832-5400
Entity
Organization
Contact information
Practice address
3300 W BREWSTER ST, APPLETON, WI 54914
(920) 832-5400
(920) 832-4922
Mailing address
3300 W BREWSTER ST, APPLETON, WI 54914
(920) 832-5400
(920) 832-4922
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2371
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20125400
—
WI
Enumeration date
10/06/2005
Last updated
05/11/2010
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