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NPI Code Detail

MEDICARE: WAUNAKEE MANOR HCC

MEDICARE: WAUNAKEE MANOR HCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility3247026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275782740
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAUNAKEE MANOR HCC
Provider Business Mailing Address
First Line : 801 S KLEIN DR
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-1575
Country : US
Telephone Number : 608-849-5016
Fax Number : 608-850-6868
Provider Business Practice Location Address
First Line : 801 S KLEIN DR
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-1575
Country : US
Telephone Number : 608-849-5016
Fax Number : 608-850-6868
Authorized Official
Title or Position : REHAB DIRECTOR
Name : DEBBIE J DENNIS
Credential : PT
Telephone Number : 608-849-5016
Provider Enumeration Date : 09/09/2008
Last Update Date : 09/09/2008

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1437326030 — MARCELLINE CHRISTINE CRUZ PETERSON MS, CCC-SLP
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Directions to “WAUNAKEE MANOR HCC ” Practice Location

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