Organization
MANOR CARE OF FOND DU LAC WI LLC
Active
Other names
ManorCare Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5743
Entity
Organization
Contact information
Practice address
265 S NATIONAL AVE, FOND DU LAC, WI 54935-5334
(920) 922-7342
(920) 922-4737
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2743
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20199900
—
WI
Enumeration date
05/26/2006
Last updated
05/11/2017
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