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Organization

DYCORA TRANSITIONAL HEALTH - BEAVER DAM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY HAWKINS (EXECUTIVE)
(920) 887-7191
Entity
Organization

Contact information

Practice address
410 ROEDL CT, BEAVER DAM, WI 53916-2934
(920) 887-7191
Mailing address
410 ROEDL CT, BEAVER DAM, WI 53916-2934
(920) 887-7191

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2695
WI

Other

Enumeration date
11/04/2016
Last updated
01/25/2018
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