Organization
1840 PRIDDY STREET OPERATING COMPANY, LLC
Active
Other names
Atrium Post Acute Care of Bloomer
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN P BRESLIN (MANAGER)
(973) 339-8892
Entity
Organization
Contact information
Practice address
1840 PRIDDY ST, BLOOMER, WI 54724-1546
(715) 568-2503
(715) 568-2518
Mailing address
1726 N BALLARD RD, APPLETON, WI 54911-2444
(920) 991-9072
(920) 749-4022
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2807
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790141158
—
WI
Enumeration date
01/14/2016
Last updated
04/05/2016
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