| Organization Name: | WISCONSIN ILLINOIS SENIOR HOUSING, INC. |
| NPI Number: | 1659371938 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA KRUCHTEN (CEO) |
| Mailing Address: | 407 N 8th St Mount Horeb |
| State: | WI US |
| Postal Code: | 535721872 |
| Phone Number: | 6084375511 |
| Fax Number: | 6084379603 |
| NPI Enumeration Date: | 07/28/2005 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | 0076 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |