Organization
LJ III HEALTH MANAGEMENT INC.
Active
Other names
Premier Rehabilitation & Skilled Nursing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE GUNDERSON (ADMINISTRATOR)
(608) 365-9526
Entity
Organization
Contact information
Practice address
2121 PIONEER DR, BELOIT, WI 53511-3025
(608) 365-9526
(608) 365-9761
Mailing address
2121 PIONEER DR, BELOIT, WI 53511-3025
(608) 365-9526
(608) 365-9761
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3061
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20185800
—
WI
Enumeration date
06/16/2005
Last updated
08/22/2020
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