Organization
DYCORA TRANSITIONAL HEALTH - GLENDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HAWKINS (EXECUTIVE)
(414) 228-8120
Entity
Organization
Contact information
Practice address
1300 W SILVER SPRING DR, GLENDALE, WI 53209-4415
(414) 228-8120
Mailing address
1300 W SILVER SPRING DR, GLENDALE, WI 53209-4415
(414) 228-8120
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
WI
Other
Enumeration date
10/21/2016
Last updated
01/24/2018
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