Theda Care Peabody Manor

LBN: Theda Care Peabody Manor
Theda Care Peabody Manor is an health care organization with primary practice located at 2600 S Heritage Woods Dr , Appleton WI 54915-1408. 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. Theda Care Peabody Manor can be contacted via phone (920) 225-7764, or through Radish, Toni Marie via phone (920) 225-7764.

Contact Information

Primary practice address
2600 S Heritage Woods Dr Appleton WI 54915-1408
Phone: (920) 225-7764
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Radish, Toni Marie MSPT
Phone: (920) 225-7764

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 9771-24 Wisconsin

Profile Details

NPI number 1265589303
LBN Legal business name Theda Care Peabody Manor
DBA Doing business as
Authorized official Radish, Toni Marie MSPT
Entity Organization
Organization subpart 1 No
Enumeration date Jan 4th, 2007
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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