NPI 1043326747

State of Wisconsin

Organisation Intellectual Disabilities Intermediate Care Facility Union Grove, WI

Practice location

Address: 21425 Spring St, Union Grove, WI 53182-9707
Phone: (262) 878-2411
Fax: (262) 878-2922

Authorised official

Name: James E Hutchison
Title: Nursing Home Administrator
Phone: (262) 878-2411

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2763 (WI)

Other Intermediate Care Facility, Intellectual Disabilities providers in Wisconsin →

Registry record

NPI: 1043326747
Entity type: Organization
NPI issued: 22 Aug 2006
Record last updated: 14 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.