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Organization

EXTENDICARE HOMES, INC.

Active
Other names
American Heritage Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization

Contact information

Practice address
425 DAVIS ST, HAMMOND, WI 54015-9615
(715) 796-2218
(715) 796-5286
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-7105

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20179200
WI
Enumeration date
11/16/2006
Last updated
04/07/2008
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