Fairhaven Corporation
NPI #1083619761 in Whitewater, Wisconsin
Provider Information
- NPI Number
- 1083619761
- Entity Type
- Organization
- Organization Name
- Fairhaven Corporation
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jun 17, 2005
- Last Updated
- Sep 1, 2020
Practice Location
- Address
- 435 W STARIN RD
- City
- Whitewater
- State
- Wisconsin
- ZIP Code
- 53190-1133
- Phone
- (262) 473-3445
Authorized Official
- Name
- DAVID GACKSTATTER
- Title
- DIRECTOR OF HR/BUSINESS SERVICES
- Phone
- (608) 322-4331
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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