Organization · Type 2 NPI

Beaver Dam Assisted Living, LLC

Assisted Living Facility · Beaver Dam, WI

NPI number 1265090559 Active

Practice location

104 Fakes Ct
Beaver Dam, WI 53916-2699

Call (920) 356-9818 Map

Mailing address

5555 W Grande Market Dr Ste A
Appleton, WI 54913-8170

Other practice locations

129 Evergreen Cir, Beaver Dam, WI 53916-3512 · (920) 356-9818

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed
Alzheimer Center (Dementia Center)	311500000X	None listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

7 other providers at this address

Other assisted living facility providers in Beaver Dam

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NPI record

NPI: 1265090559
Entity type: Organization (Type 2)
Issued: May 31, 2019
Last updated: Jul 3, 2020
Status: Active

Other names

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Beaver Dam Assisted Living and Memory Care · doing business as
Beaver Dam Assisted Living and Memory Care · doing business as

Authorized official

Miss Barbara Ann Bittner
COO
(920) 378-1913

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1265090559

Beaver Dam Assisted Living, LLC's National Provider Identifier is 1265090559, issued on May 31, 2019. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Beaver Dam, WI. The record was last updated on Jul 3, 2020.