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General NPI Number Information
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NPI Number | 1982015459
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Entity Type | Organization
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Legal Business Name | THOUSAND HILLS HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/18/2014
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Last Update Date | 05/18/2014
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Provider Practice Location Address
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Address Line | N2359 SCHACHT RD
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City | MARINETTE
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State | WI
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Zip | 54143-9735
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Country | US
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Telephone | 715-582-2940
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Fax | 715-582-2940
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Provider Business Mailing Address
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Address Line | N2359 SCHACHT RD
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City | MARINETTE
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State | WI
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Zip | 54143-9735
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Country | US
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Telephone |
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Fax | 715-582-2940
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Authorized Official
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Title or Position | MANAGER
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Name | KIMBERLEE THILL
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Credential | RN
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Telephone | 715-923-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 29899-020
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License Number State | WI
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