Provider Demographics
NPI:1518026566
Name:FIRST AMERICAN ENTERPRISES INC
Entity Type:Organization
Organization Name:FIRST AMERICAN ENTERPRISES INC
Other - Org Name:RICE LAKE CONVALESCENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-844-0308
Mailing Address - Street 1:1016 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-1225
Mailing Address - Country:US
Mailing Address - Phone:715-234-9101
Mailing Address - Fax:715-234-4021
Practice Address - Street 1:1016 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-1225
Practice Address - Country:US
Practice Address - Phone:715-234-9101
Practice Address - Fax:715-234-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2462314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20156300Medicaid
WI20156300Medicaid