St Joseph Residence INC
NPI #1073510632 in New London, Wisconsin
Provider Information
- NPI Number
- 1073510632
- Entity Type
- Organization
- Organization Name
- St Joseph Residence INC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jun 28, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 107 E BECKERT ROAD
- City
- New London
- State
- Wisconsin
- ZIP Code
- 54961-2598
- Phone
- (920) 982-5354
Authorized Official
- Name
- MR. DANIEL W ORR
- Title
- ADMINISTRATOR
- Phone
- (920) 982-5354
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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