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General NPI Number Information
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NPI Number | 1023006814
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Entity Type | Organization
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Legal Business Name | REEDSBURG AREA SENIOR LIFE CENTER INC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 04/04/2016
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Provider Practice Location Address
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Address Line | 2350 N DEWEY AVE
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City | REEDSBURG
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State | WI
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Zip | 53959
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Country | US
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Telephone | 608-524-6577
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Fax | 608-524-0757
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Provider Business Mailing Address
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Address Line | 2350 N DEWEY AVE
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City | REEDSBURG
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State | WI
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Zip | 53959
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Country | US
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Telephone | 608-524-6577
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Fax | 608-524-0757
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Authorized Official
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Title or Position | VP SENIOR SERVICES
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Name | RYAN SHEAR
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Credential |
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Telephone | 608-768-5805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2297
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License Number State | WI
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