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Contact Information

SHELL LAKE SNF LLC
802 E CTY HWY B
SHELL LAKE, WI54871
 Phone: 715-468-4292
 Fax: 715-468-4232
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
 

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for SHELL LAKE SNF LLC

NPI Number 1295939049
LBN Legal business name SHELL LAKE SNF LLC
Authorized official JONATHON HANSEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/14/2007
Last updated 08/18/2025 - About 10 months ago
Identifiers
WI License # 2748
WI Other 2748 BUSINESS LICENSE NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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