St Joseph Residence Inc

LBN: St Joseph Residence Inc
St Joseph Residence Inc is an health care organization with primary practice located at 107 E Beckert Road , New London WI 54961-2598. 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. St Joseph Residence Inc can be contacted via phone (920) 982-5354, or through Orr, Daniel W via phone (920) 982-5354.

Contact Information

Primary practice address
107 E Beckert Road New London WI 54961-2598
Phone: (920) 982-5354
Fax: (920) 982-5420
Website:
Map and Directions
Authorized official contact:
Name: Orr, Daniel W
Phone: (920) 982-5354

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 2040 Wisconsin

Profile Details

NPI number 1073510632
LBN Legal business name St Joseph Residence Inc
DBA Doing business as
Authorized official Orr, Daniel W
Entity Organization
Organization subpart 1 No
Enumeration date Jun 28th, 2005
Last updated Aug 22nd, 2020 - about 4 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 1073510632 NPPES
Wisconsin MEDICAID 20132400

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