Ccc of East Fond Du Lac
NPI #1972089399 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1972089399
- Entity Type
- Organization
- Organization Name
- Ccc of East Fond Du Lac
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 18, 2018
- Last Updated
- Jul 18, 2018
Practice Location
- Address
- 265 S NATIONAL AVE
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54935-5334
- Phone
- (847) 983-4860
Authorized Official
- Name
- DAVID MERZEL
- Title
- CFO
- Phone
- (847) 983-4860
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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