FMG Davis Street SNF Wisconsin LLC
Organization Active NPI Skilled Nursing Facility · Hammond, WI
NPI 1104215060 · NPPES record last updated Jan 16, 2015
Key facts
- NPI
- 1104215060
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- FMG DAVIS STREET SNF WISCONSIN LLC
- Practice address
- 425 Davis St
Hammond, WI 54015-9615 - Phone
- (715) 796-2218
- Fax
- (715) 796-5286
- NPI assigned
- Jan 15, 2015
- Organization subpart
- No
Authorized official
- Name
- David Keating
- Title
- Authorized Official
- Phone
- (414) 908-8058
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
425 Davis St
Hammond, WI 54015-9615
Mailing address
425 Davis St
Hammond, WI 54015-9615
Phone (715) 796-2218
Other names
- American Heritage
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All providers in Hammond, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.