Organization
FMG NEW PINE DRIVE WISCONSIN LLC
Active
Other names
Oakwood Villa
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
2512 NEW PINE DR, ALTOONA, WI 54720-1378
(715) 833-0400
(715) 833-0546
Mailing address
2512 NEW PINE DR, ALTOONA, WI 54720-1378
(715) 833-0400
(715) 833-0546
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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