Organization
SHEBOYGAN SENIOR COMMUNITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN KLEIST RN, HNA (ADMINISTRATOR)
(920) 458-2137
Entity
Organization
Contact information
Practice address
3505 CTY RD. Y, SHEBOYGAN, WI 53083-2400
(920) 458-2137
(920) 458-5922
Mailing address
3505 CTY RD. Y, SHEBOYGAN, WI 53083-2400
(920) 458-2137
(920) 458-5922
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2662
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20158600
—
WI
Enumeration date
07/08/2005
Last updated
11/23/2015
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