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Organization

FOND DU LAC COUNTY

Active
Other names
Harbor Haven Health & Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
MARK RADMER (ADMINISTRATOR)
(920) 929-3309
Entity
Organization

Contact information

Practice address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3543
(920) 929-7509
Mailing address
459 E 1ST ST, FOND DU LAC, WI 54935-4505
(920) 929-3543
(920) 929-7509

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2437
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20130800
WI
Enumeration date
12/23/2005
Last updated
07/16/2019
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