Organization
GLENHAVEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROLF DONHOWE (ADMINISTRATOR)
(715) 265-4555
Entity
Organization
Contact information
Practice address
612 E OAK ST, GLENWOOD CITY, WI 54013-8520
(715) 265-4555
Mailing address
612 E OAK ST, GLENWOOD CITY, WI 54013-8520
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0852
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20157600
—
WI
Enumeration date
07/26/2006
Last updated
08/22/2020
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