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General NPI Number Information
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NPI Number | 1275176133
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Entity Type | Organization
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Legal Business Name | NSH MENOMINEE LLC
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 501 2ND ST
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City | MENOMINEE
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State | MI
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Zip | 49858-3203
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Country | US
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Telephone | 906-863-9941
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 N PORT WASHINGTON RD STE 260
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City | MILWAUKEE
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State | WI
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Zip | 53217-5470
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Country | US
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Telephone | 414-962-5250
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JEFFREY HOEHN
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Credential |
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Telephone | 414-962-5250
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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 |
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License Number State |
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