Organization
KETTLE PARK SENIOR LIVING INC
Active
Other names
Kettle Park Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA LIES (DIRECTOR OF FINANCIAL SERVICES)
(952) 888-2923
Entity
Organization
Contact information
Practice address
2600 JACKSON ST, STOUGHTON, WI 53589-9142
(608) 579-5601
Mailing address
2600 JACKSON ST, STOUGHTON, WI 53589-9142
(608) 579-5601
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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