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Organization
LUTHERAN HOMES OF OCONOMOWOC INC.
Active
Organization
LUTHERAN HOMES OF OCONOMOWOC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN BIRR (CHIEF FINANCIAL OFFICER)
(262) 560-6969
Entity
Organization
Contact information
Practice address
1305 W WISCONSIN AVE, OCONOMOWOC, WI 53066-2646
(262) 560-6964
(262) 567-7189
Mailing address
PO BOX 208, OCONOMOWOC, WI 53066-0208
(262) 560-6964
(262) 567-7189
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20152300
—
WI
Enumeration date
09/22/2005
Last updated
12/16/2011
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