OrganizationActive
1311 Tyler Street Operating Company, LLC
NPI 1336505791 · Skilled Nursing Facility · Black River Falls, WI
Provider details
- NPI number
- 1336505791
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- Kevin Breslin, Manager
- License
- 3211 (WI)
Practice location
1311 Tyler St
Black River Falls, WI 54615-1564
Phone: (715) 284-4396
Fax: (715) 284-9580
Mailing address
1726 N Ballard Rd
Appleton, WI 54911-2444
Registry dates
- Enumerated
- 2016-01-14
- Last updated
- 2016-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.