Provider Demographics
NPI:1689671109
Name:ZUNKER HEALTH CARE INC
Entity Type:Organization
Organization Name:ZUNKER HEALTH CARE INC
Other - Org Name:GRANCARE NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:920-494-4525
Mailing Address - Street 1:1555 DOUSMAN ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-3207
Mailing Address - Country:US
Mailing Address - Phone:920-494-4525
Mailing Address - Fax:920-494-2816
Practice Address - Street 1:1555 DOUSMAN ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3207
Practice Address - Country:US
Practice Address - Phone:920-494-4525
Practice Address - Fax:920-494-2816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3131314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20174100Medicaid
WI525486Medicare ID - Type UnspecifiedMEDICARE