Lincoln Lutheran Home Of Racine Inc

NPI 1215011317 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1215011317
Enumeration Date 10/25/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JERRY GLEN JERRY
Position CHIEF FINANCIAL OFFICER
Phone (262) 637-9751
Fax (262) 633-3045
Practice Location
1700 CA BECKER DRIVE
RACINE WI, 53406, US
Phone (262) 637-9751
Fax (262) 633-3045
Business Location
2000 DOMANIK DRIVE
RACINE WI, 53404, US
Phone (262) 633-0500
Fax (262) 633-3045
Toxanomy
Taxonomy Code 314000000X
License State Wisconsin
License Number 2269
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According to our database, Lincoln Lutheran Home Of Racine Inc NPI is 1215011317, taxonomy code is 314000000X and license number is 2269, license state is located at Wisconsin. Lincoln Lutheran Home Of Racine Inc physically located at 1700 Ca Becker Drive, Racine WI, 53406. NPI Number 1033115704 has the healthcare provider type.

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1215011317 NPI number is provided on an as is basis without warranty of any kind. 1215011317 is maintained by the National Plan & Provider Enumeration System. The contents of Lincoln Lutheran Home Of Racine Inc are for informational purposes only.