OrganizationActive
County of Shawano
NPI 1720088495 · Intellectual Disabilities Intermediate Care Facility · Shawano, WI
Provider details
- NPI number
- 1720088495
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Debbra Kessen, Accountant/Controller(715) 526-3158
- License
- 2994 (WI)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
N4231 State Highway 22
Shawano, WI 54166-6130
Phone: (715) 526-3158
Fax: (715) 526-6823
Approximate (ZIP-level) locationGet directions
Mailing address
N4231 State Highway 22
Shawano, WI 54166-6130
Other names (DBA / former)
- Doing business as
- Maple Lane Health Care Center
Registry dates
- Enumerated
- 2005-07-26
- Last updated
- 2007-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.