Healthcare Provider Details

I. General information

NPI: 1669467106
Provider Name (Legal Business Name): SNOWHILL HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7490 156TH ST
CHIPPEWA FALLS WI
54729-1425
US

IV. Provider business mailing address

7490 156TH ST
CHIPPEWA FALLS WI
54729-1425
US

V. Phone/Fax

Practice location:
  • Phone: 715-723-9341
  • Fax: 715-723-0263
Mailing address:
  • Phone: 715-723-9341
  • Fax: 715-723-0263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3168
License Number StateWI

VIII. Authorized Official

Name: DEBRA BOYD
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 715-723-9341