Organization · Type 2 NPI

Fond Du Lac Lutheran Home, Inc.

Skilled Nursing Facility · Fond Du Lac, WI

NPI number 1649266404 Active

Practice location

244 N Macy St
Fond Du Lac, WI 54935-3362

Fax (920) 921-0819

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility	310400000X	None listed
Skilled Nursing Facility Primary	314000000X	0047 (WI)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

11 other providers at this address

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NPI record

NPI: 1649266404
Entity type: Organization (Type 2)
Issued: Sep 26, 2005
Last updated: Jul 10, 2026
Status: Active

Other names

<unavail>
Fond Du Lac Lutheran Home · doing business as
Lutheran Home and Health Services · doing business as
Tarfa Terrace · doing business as
Wellness and Rehab Center · doing business as

Authorized official

Julie Anne Marks
CFO
(920) 261-0400

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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 1649266404

Fond Du Lac Lutheran Home, Inc.'s National Provider Identifier is 1649266404, issued on Sep 26, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Fond Du Lac, WI. The record was last updated on Jul 10, 2026.