Organization
CCC OF EAST GREEN BAY
Active
Other names
Crossroads Care Center of East Green Bay
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L MERZEL (CFO)
(847) 983-4860
Entity
Organization
Contact information
Practice address
600 S WEBSTER AVE, GREEN BAY, WI 54301-3503
(920) 432-3213
Mailing address
8150 CENTRAL PARK AVE, SKOKIE, IL 60076-2974
(847) 983-4860
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
WI
Enumeration date
07/18/2018
Last updated
03/29/2019
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