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Organization

AUGUSTA AREA HOME, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAHN B BRADLEY (ADMINISTRATOR)
(715) 286-2266
Entity
Organization

Contact information

Practice address
901 BRIDGE CREEK LN, AUGUSTA, WI 54722-2603
(715) 286-2266
(715) 286-2653
Mailing address
901 BRIDGE CREEK LN, AUGUSTA, WI 54722-2603
(715) 286-2266
(715) 286-2653

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
314000000X
Skilled Nursing Facility
Primary
2083
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20010300
WI
Enumeration date
09/23/2005
Last updated
01/13/2025
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