Organization
JACKSON PINE VIEW HEALTHCARE, LLC
Active
Other names
Pine View Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN M MARSH (VICE PRESIDENT)
(608) 242-5024
Entity
Organization
Contact information
Practice address
400 COUNTY ROAD R, BLACK RIVER FALLS, WI 54615-5129
(715) 284-5396
Mailing address
400 COUNTY ROAD R, BLACK RIVER FALLS, WI 54615-5129
(608) 225-2516
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2440
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20198400
—
WI
Enumeration date
08/30/2006
Last updated
06/17/2008
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