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Organization
BAY AREA LUTHERAN HOMES INC
Active
Organization
BAY AREA LUTHERAN HOMES INC
Active
Other names
Woodside Lutheran Home
Organization subpart
No
Provider details
NPI number
Authorized official
POLLY GRETZINGER (EXECUTIVE DIRECTOR, CAMPUS OPERATIO)
(920) 405-3213
Entity
Organization
Contact information
Practice address
1040 PILGRIM WAY, GREEN BAY, WI 54304
(920) 499-1481
(920) 499-1501
Mailing address
1040 PILGRIM WAY, GREEN BAY, WI 54304
(920) 499-1481
(920) 499-1501
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
2177
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20150200
—
WI
Enumeration date
11/14/2006
Last updated
10/13/2023
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