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General NPI Number Information
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NPI Number | 1740352673
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Entity Type | Organization
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Legal Business Name | ZASTROW CARE CENTER INC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 W HICKORY STREET
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City | GILMAN
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State | WI
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Zip | 54433-0218
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Country | US
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Telephone | 715-447-8217
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Fax | 715-447-5775
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | GILMAN
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State | WI
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Zip | 54433-0218
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Country | US
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Telephone | 715-447-8217
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Fax | 715-447-5775
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. WAYNE C ZASTROW
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Credential | NHA
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Telephone | 715-447-8217
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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 | 3091
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License Number State | WI
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