Organization
RACINE COUNTY
Active
Other names
Ridgewood Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM L MCREYNOLDS (COUNTY EXECUTIVE)
(262) 636-3273
Entity
Organization
Contact information
Practice address
3205 WOOD RD, RACINE, WI 53406-5048
(262) 554-6440
(262) 554-5119
Mailing address
3205 WOOD RD, RACINE, WI 53406-5048
(262) 554-6440
(262) 554-5119
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2925
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20130700
—
WI
Enumeration date
06/14/2005
Last updated
01/14/2008
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