Organization
WOODLAND VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANKER (COTA)
(920) 842-2191
Entity
Organization
Contact information
Practice address
430 MANOR DR, SURING, WI 54174-9182
(902) 842-2191
Mailing address
1111 S RIVER ST, SHAWANO, WI 54166-3229
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1530-027
WI
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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