NPI 1194723205 · live from the CMS NPI Registry
Ccg Tomah INC.
Skilled Nursing Facility in Tomah, WI. National Provider Identifier 1194723205, active.
NPI record
| NPI | 1194723205 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1505 Butts Ave, Tomah, WI 54660 |
| Practice phone | 608-372-3241 |
| Mailing address | 5000 Hakes Dr, Suite 600, Norton Shores, MI 49441 |
| Enumerated | July 12, 2005 |
| Last updated | January 23, 2008 |
| Authorized official | Keith Yoder, Cfo |
| Other names | Tomah Health Care Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | 2825 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.