Organization
JMH ENTERPRISES, LLC
Active
Other names
Crystal Lake Manor
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHARLES HALBLEIB (MANAGING MEMBER LLC)
(715) 877-2411
Entity
Organization
Contact information
Practice address
208 ELM STREET, STRUM, WI 54770-0009
(715) 695-2611
(715) 695-3185
Mailing address
PO BOX 9, STRUM, WI 54770-0009
(715) 695-2611
(715) 695-3185
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2205
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20195800
—
WI
Enumeration date
01/31/2007
Last updated
08/22/2020
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