Organization
NORTHLAND LUTHERAN HOME HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GUSTAFSON (DIRECTOR OF FINANCE)
(715) 732-0155
Entity
Organization
Contact information
Practice address
925 PINE BEACH RD, MARINETTE, WI 54143-4227
(715) 735-6222
(715) 735-6221
Mailing address
925 PINE BEACH RD, MARINETTE, WI 54143-4227
(715) 735-6222
(715) 735-6221
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
256
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2828102
—
MI
05
—
415-27500
—
WI
Enumeration date
05/31/2005
Last updated
10/14/2015
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