Dallas Healthcare Center Inc.
Organization Active NPI Skilled Nursing Facility · Dallas, WI
NPI 1396896643 · NPPES record last updated Jul 11, 2007
Key facts
- NPI
- 1396896643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 3039 (WI)
- Legal business name
- DALLAS HEALTHCARE CENTER INC.
- Practice address
- 104 E Dallas St
Dallas, WI 54733-9699 - Phone
- (715) 837-1222
- Fax
- (715) 837-1713
- NPI assigned
- Jan 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Len F Fast
- Title
- Administrator
- Phone
- (715) 837-1222
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3039 | WI | Yes |
Addresses
Primary practice location
104 E Dallas St
Dallas, WI 54733-9699
Mailing address
104 E Dallas St
P.O. Box 220
Dallas, WI 54733-9699
Phone (715) 837-1222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20167500 | Medicaid | WI |
Other providers in Dallas, WI
All providers in Dallas, 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 Jul 11, 2007. 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.