Organization
BETHESDA LUTHERAN COMMUNITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD SCHUTTE (DIRECTOR OF ACCOUNTS RECEIVABLE)
(920) 206-4486
Entity
Organization
Contact information
Practice address
600 HOFFMANN DR, WATERTOWN, WI 53094-6223
(920) 261-3050
Mailing address
600 HOFFMANN DR, WATERTOWN, WI 53094-6223
(920) 261-3050
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99533340
—
WI
Enumeration date
10/18/2010
Last updated
02/24/2017
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