Organization
FMG NORTH SUMMIT VILLAGE WAY WISCONSIN LLC
Active
Other names
Lake Country Health & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
2195 N SUMMIT VILLAGE WAY, SUMMIT, WI 53066-8675
(262) 567-4662
Mailing address
2195 N SUMMIT VILLAGE WAY, SUMMIT, WI 53066-8675
(262) 567-4662
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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