State of Wisconsin
NPI #1558615815 in Chippewa Falls, Wisconsin
Provider Information
- NPI Number
- 1558615815
- Entity Type
- Organization
- Organization Name
- State of Wisconsin
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Nov 7, 2012
- Last Updated
- Jan 6, 2026
Practice Location
- Address
- 2175 E PARK AVE
- City
- Chippewa Falls
- State
- Wisconsin
- ZIP Code
- 54729-3511
- Phone
- (715) 720-6775
Authorized Official
- Name
- TAMMY L SERVATIUS
- Title
- HOMES DIVISION ADMINISTRATOR
- Phone
- (715) 258-4251
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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