Medicaid
NPI #1336109776 in Menasha, Wisconsin
Provider Information
- NPI Number
- 1336109776
- Entity Type
- Organization
- Organization Name
- Medicaid
- Primary Specialty
- Custodial Care Facility
- Enumeration Date
- Mar 27, 2006
- Last Updated
- Sep 11, 2025
Practice Location
Authorized Official
- Name
- MISS LORI ANN FARRAGH
- Title
- RN
- Phone
- (920) 450-8323
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility - Nursing Care, Pediatric — Nursing Care, Pediatric |
| Custodial Care Facility |
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