Hetzel Care Center, Inc

Organization Active NPI Skilled Nursing Facility · Bloomer, WI

NPI 1104813005 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1104813005
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
2807 (WI)
Legal business name
HETZEL CARE CENTER, INC
Practice address
1840 Priddy St
Bloomer, WI 54724-1546
Phone
(715) 568-2503
Fax
(715) 568-2518
NPI assigned
Oct 5, 2005
Organization subpart
No

Authorized official

Name
Gordon Hetzel
Title
President
Phone
(715) 568-2503

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2807 WI Yes

Addresses

Primary practice location

1840 Priddy St
Bloomer, WI 54724-1546

Mailing address

1840 Priddy St
Bloomer, WI 54724-1546
Phone (715) 568-2503

Other identifiers

IdentifierTypeStateIssuer
20162200MedicaidWI

Other providers in Bloomer, WI

All providers in Bloomer, WI · Skilled Nursing Facility in Wisconsin

Sources for this page

Verify at the official NPI Registry.