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Organization

FMG SOUTH CHICAGO AVENUE WISCONSIN LLC

Active
Other names
Willowcrest Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization

Contact information

Practice address
3821 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3712
(414) 762-7336
Mailing address
3821 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3712
(414) 762-7336

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
02/24/2015
Last updated
02/24/2015
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