- Enrollment id
- O20200114003194
- Enrollment state
- WI
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1245873199
- Multiple npi flag
- N
- Ccn
- 525353
- Associate id
- 1951736248
- Organization name
- NSH STEVENS POINT LLC
- Doing business as name
- STEVENS POINT HEALTH SERVICES
- Incorporation date
- 2019-09-25
- Incorporation state
- WI
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- STEVENS POINT HEALTH SERVICES
- Affiliation entity name
- NORTH SHORE HEALTHCARE
- Affiliation entity id
- 377
- Address line 1
- 1800 SHERMAN AVE
- City
- STEVENS POINT
- State
- WI
- Zip code
- 544817215