Organization
HETZEL CARE NURSING & REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOSHE ORLINSKY (MANAGING MEMEBER)
(314) 588-7518
Entity
Organization
Contact information
Practice address
1840 PRIDDY ST, BLOOMER, WI 54724-1546
(314) 588-7518
Mailing address
211 N BROADWAY STE 2035, SAINT LOUIS, MO 63102-2711
(314) 588-7518
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2807
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012962
—
WI
05
—
20162200
—
WI
Enumeration date
12/22/2010
Last updated
07/12/2011
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