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General NPI Number Information
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NPI Number | 1790963411
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Entity Type | Organization
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Legal Business Name | LIFECARE HOSPITAL OF WISCONSIN
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 2400 GOLF RD
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City | PEWAUKEE
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State | WI
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Zip | 53072-5590
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Country | US
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Telephone | 262-524-2624
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 GOLF RD
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City | PEWAUKEE
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State | WI
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Zip | 53072-5590
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIETITIAN
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Name | MS. CHRISTIE LYNNE SCHULTZ
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Credential | RD, CD, CNSD
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Telephone | 262-524-2624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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