Organization
TERRACEVIEW LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT GRAVES (ADMINISTRATOR)
(715) 468-7292
Entity
Organization
Contact information
Practice address
802 E COUNTY HIGHWAY B, SHELL LAKE, WI 54871-4425
(715) 468-7292
(715) 468-4323
Mailing address
802 E COUNTY HIGHWAY B, PO BOX 609, SHELL LAKE, WI 54871-4425
(715) 468-7292
(715) 468-4323
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2748
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20114500
—
WI
Enumeration date
11/07/2005
Last updated
03/05/2008
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