Organization
PETERSEN HEALTH CARE OF WI, INC.
Active
Other names
Friendly Village
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA ALLARD NHA (NURSING HOME ADMINISTRATOR)
(715) 365-6449
Entity
Organization
Contact information
Practice address
900 BOYCE DR, RHINELANDER, WI 54501-3835
(715) 365-6900
(715) 365-6665
Mailing address
900 BOYCE DR, P.O. BOX 857, RHINELANDER, WI 54501-3835
(715) 365-6900
(715) 365-6665
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2751
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20114800
—
WI
Enumeration date
08/11/2005
Last updated
08/22/2020
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