Extendicare Homes, Inc.
NPI #1407927148 in Port Washington, Wisconsin
Provider Information
- NPI Number
- 1407927148
- Entity Type
- Organization
- Organization Name
- Extendicare Homes, Inc.
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Nov 13, 2006
- Last Updated
- Apr 7, 2008
Practice Location
- Address
- 1119 N WISCONSIN ST
- City
- Port Washington
- State
- Wisconsin
- ZIP Code
- 53074-1209
- Phone
- (262) 284-5892
Authorized Official
- Name
- DONNA JO MAASSEN
- Title
- DIRECTOR OF COMPLIANCE
- Phone
- (414) 908-8119
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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