Organization
REST HAVEN HEALTH CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN M. KRUCHTEN (OWNER)
(608) 849-5016
Entity
Organization
Contact information
Practice address
7672 W MINERAL POINT RD, VERONA, WI 53593-9668
(608) 833-1691
(608) 833-0492
Mailing address
7672 W MINERAL POINT RD, VERONA, WI 53593-9668
(608) 833-1691
(608) 833-0492
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0965
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20186000
—
WI
Enumeration date
10/12/2005
Last updated
01/31/2008
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