Provider Demographics
NPI:1659942316
Name:ARBOR VILLAGE INC
Entity Type:Organization
Organization Name:ARBOR VILLAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAFURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-801-0388
Mailing Address - Street 1:620 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:PESHTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54157-1134
Mailing Address - Country:US
Mailing Address - Phone:715-801-0388
Mailing Address - Fax:715-408-4481
Practice Address - Street 1:620 HARPER AVE
Practice Address - Street 2:
Practice Address - City:PESHTIGO
Practice Address - State:WI
Practice Address - Zip Code:54157-1134
Practice Address - Country:US
Practice Address - Phone:715-801-0388
Practice Address - Fax:715-408-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385H00000XRespite Care FacilityRespite Care