Local City Search for Care Homes, Nursing Homes, Assisted Living, Skilled Nursing and Home CareSTATE OF WISCONSIN
Intermediate Care Facility, Mentally Retarded
Union Grove, Wisconsin
Provider NPI: 1043326747
Organization Information:Organization Name: STATE OF WISCONSIN
Practice Location:
21425 SPRING ST UNION GROVE, WI 53182 US
Tel: 262-878-2411 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
21425 SPRING ST UNION GROVE, WI 53182 US
Tel: 262-878-2411 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | WI | 2763 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 21050000 | WI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
