Shady Lane Home, Inc.
NPI #1518926211 in Manitowoc, Wisconsin
Provider Information
- NPI Number
- 1518926211
- Entity Type
- Organization
- Organization Name
- Shady Lane Home, Inc.
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Mar 21, 2006
- Last Updated
- Dec 31, 2020
Practice Location
Authorized Official
- Name
- LISA M WETENKAMP
- Title
- ACCOUNTS RECEIVABLE
- Phone
- (920) 682-8254
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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