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General NPI Number Information
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NPI Number | 1932118452
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Entity Type | Organization
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Legal Business Name | TBN, LLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 505 W 8TH ST
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City | NEW RICHMOND
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State | WI
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Zip | 54017-1524
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Country | US
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Telephone | 715-246-6851
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Fax | 715-246-1065
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Provider Business Mailing Address
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Address Line | 505 W 8TH ST
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City | NEW RICHMOND
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State | WI
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Zip | 54017-1524
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Country | US
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Telephone | 715-246-6851
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Fax | 715-246-1065
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN CHARLES HALBLEIB
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Credential |
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Telephone | 715-877-2411
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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 | NOT YET ISSUED
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License Number State | WI
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