Provider Demographics
NPI:1871654301
Name:WANDA PREISLER
Entity Type:Organization
Organization Name:WANDA PREISLER
Other - Org Name:PARK PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-762-3622
Mailing Address - Street 1:349 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:PARK FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54552-1302
Mailing Address - Country:US
Mailing Address - Phone:715-762-3622
Mailing Address - Fax:715-762-4982
Practice Address - Street 1:349 1ST AVE N
Practice Address - Street 2:
Practice Address - City:PARK FALLS
Practice Address - State:WI
Practice Address - Zip Code:54552-1302
Practice Address - Country:US
Practice Address - Phone:715-762-3622
Practice Address - Fax:715-762-4982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI610280310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility