Pine Haven Christian Home Inc

LBN: Pine Haven Christian Home Inc
Pine Haven Christian Home Inc is an health care organization with primary practice located at 220 Haven Drive , Sheboygan Falls WI 53085. 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. Pine Haven Christian Home Inc can be contacted via phone (920) 467-2401, or through Halverson, Martin via phone (920) 550-5257.

Contact Information

Primary practice address
220 Haven Drive Sheboygan Falls WI 53085
Phone: (920) 467-2401
Fax: (920) 467-7273
Website:
Map and Directions
Authorized official contact:
Name: Halverson, Martin
Phone: (920) 550-5257

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 356 Wisconsin

Profile Details

NPI number 1881688059
LBN Legal business name Pine Haven Christian Home Inc
DBA Doing business as
Authorized official Halverson, Martin
Entity Organization
Organization subpart 1 No
Enumeration date Sep 2nd, 2005
Last updated Jun 22nd, 2015 - about 9 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 1881688059 NPPES
Wisconsin MEDICAID 20012000

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