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General NPI Number Information
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NPI Number | 1831584937
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Entity Type | Organization
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Legal Business Name | RENNES ASSISTED LIVING CORP
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 250 S 9TH ST
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City | DE PERE
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State | WI
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Zip | 54115-3919
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Country | US
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Telephone | 920-983-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 250 S 9TH ST
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City | DE PERE
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State | WI
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Zip | 54115-3919
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Country | US
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Telephone | 920-983-5100
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | NEIL JOHNSON
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Credential |
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Telephone | 715-582-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 14532
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License Number State | WI
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