Organization
SUNDANCE SERVICES CORP
Active
Other names
Genesis Rehab Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI FREISINGER O.T. (AREA MANAGER)
(414) 531-5226
Entity
Organization
Contact information
Practice address
107 E BECKERT RD, NEW LONDON, WI 54961-2509
(920) 982-5354
(920) 982-9149
Mailing address
107 E BECKERT RD, NEW LONDON, WI 54961-2509
(920) 982-5354
(920) 982-9149
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3026-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3026-154
STATE OF WISCONSIN - DSPS LICENSE RENEWAL
WI
05
—
42591500
—
WI
Enumeration date
01/24/2013
Last updated
01/24/2013
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