OrganizationActive
State of Wisconsin
NPI 1043326747 · Intellectual Disabilities Intermediate Care Facility · Union Grove, WI
Provider details
- NPI number
- 1043326747
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- James Hutchison, Nursing Home Administrator(262) 878-2411
- License
- 2763 (WI)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
21425 Spring St
Union Grove, WI 53182-9707
Phone: (262) 878-2411
Fax: (262) 878-2922
Approximate (ZIP-level) locationGet directions
Mailing address
21425 Spring St
Union Grove, WI 53182-9707
Other names (DBA / former)
- Doing business as
- Southern Wisconsin Center
Registry dates
- Enumerated
- 2006-08-22
- Last updated
- 2008-02-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.