COUNTY OF OUTAGAMIE
Assisted Living Facility
Appleton, Wisconsin
Provider NPI: 1639167430
Organization Information:Organization Name: COUNTY OF OUTAGAMIE
Practice Location:
3300 W BREWSTER ST APPLETON, WI 54914 US
Tel: 920-832-5400 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
3300 W BREWSTER ST APPLETON, WI 54914 US
Tel: 920-832-5400 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | WI | 2371 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
20125400 | WI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin