Organization
LSS OF SHEBOYGAN, LLC
Active
Other names
Sunny Ridge Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNE STARK (ADMINISTRATOR)
(920) 459-3028
Entity
Organization
Contact information
Practice address
3014 ERIE AVE, SHEBOYGAN, WI 53081-3658
(920) 459-3028
(920) 459-4341
Mailing address
3014 ERIE AVENUE, SHEBOYGAN, WI 53081
(920) 459-3028
(920) 459-4341
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2363
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20198500
—
WI
Enumeration date
11/14/2006
Last updated
07/17/2007
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