Provider Demographics
NPI:1497892756
Name:ASPIRUS LILLIAN KERR HEALTHCARE CENTER
Entity Type:Organization
Organization Name:ASPIRUS LILLIAN KERR HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:715-545-3984
Mailing Address - Street 1:2383 STATE HWY 17
Mailing Address - Street 2:
Mailing Address - City:PHELPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555
Mailing Address - Country:US
Mailing Address - Phone:715-545-3984
Mailing Address - Fax:715-545-3412
Practice Address - Street 1:2383 STATE HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:PHELPS
Practice Address - State:WI
Practice Address - Zip Code:54554-9472
Practice Address - Country:US
Practice Address - Phone:715-545-3984
Practice Address - Fax:715-545-3412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1009026314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility