Brewster Village

LBN: County Of Outagamie
Brewster Village is an health care organization with primary practice located at 3300 W Brewster St , Appleton WI 54914. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. County Of Outagamie can be contacted via phone (920) 832-5400, or through Rothmann, David A via phone (920) 832-5400.

Contact Information

Primary practice address
3300 W Brewster St Appleton WI 54914
Phone: (920) 832-5400
Fax: (920) 832-4922
Website:
Map and Directions
Authorized official contact:
Name: Rothmann, David A NHM ADMINISTRATOR
Phone: (920) 832-5400

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 2371 Wisconsin

Profile Details

NPI number 1639167430
LBN Legal business name County Of Outagamie
DBA Doing business as Brewster Village
Authorized official Rothmann, David A NHM ADMINISTRATOR
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2005
Last updated May 11th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639167430 NPPES
Wisconsin MEDICAID 20125400

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