NPI 1053803031

Lake Terrace Nursing and Rehab LLC

Organisation Skilled Nursing Facility Milwaukee, WI

Practice location

Address: 2115 E Woodstock Pl, Milwaukee, WI 53202-1342
Phone: (414) 271-1020
Mailing address: 8170 McCormick Blvd STE 112, Skokie, IL 60076-2914

Authorised official

Name: Max Stesel
Title: Owner
Phone: (773) 825-3336

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 3150 (WI)

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Registry record

NPI: 1053803031
Entity type: Organization
NPI issued: 5 Jun 2018
Record last updated: 16 Sep 2020

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.