NPI 1720088495

County of Shawano

Organisation Intellectual Disabilities Intermediate Care Facility Shawano, WI

Practice location

Address: N4231 State Highway 22, Shawano, WI 54166-6130
Phone: (715) 526-3158
Fax: (715) 526-6823

Authorised official

Name: Debbra R Kessen
Title: Accountant/Controller
Phone: (715) 526-3158

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2994 (WI)

Other Intermediate Care Facility, Intellectual Disabilities providers in Wisconsin →

Registry record

NPI: 1720088495
Entity type: Organization
NPI issued: 26 Jul 2005
Record last updated: 10 Sep 2007

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.