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General NPI Number Information
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NPI Number | 1659942316
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Entity Type | Organization
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Legal Business Name | ARBOR VILLAGE INC
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Dates
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Enumeration Date | 07/05/2021
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Last Update Date | 07/05/2021
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Provider Practice Location Address
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Address Line | 620 HARPER AVE
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City | PESHTIGO
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State | WI
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Zip | 54157-1134
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Country | US
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Telephone | 715-801-0388
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Fax | 715-408-4481
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Provider Business Mailing Address
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Address Line | 620 HARPER AVE
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City | PESHTIGO
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State | WI
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Zip | 54157-1134
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Country | US
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Telephone | 715-801-0388
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Fax | 715-408-4481
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NANCY KAFURA
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Credential |
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Telephone | 715-801-0388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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