Organization
PLATINUM COMMUNITIES - RACINE LLC
Active
Other names
The Pillars at Crystal Bay
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TERESINSKI (MANAGING DIRECTOR)
(414) 940-6608
Entity
Organization
Contact information
Practice address
3950 N MAIN ST, RACINE, WI 53402-3683
(262) 639-1100
(262) 833-0370
Mailing address
2448 S 102ND ST STE 305, WEST ALLIS, WI 53227-2141
(414) 940-6608
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017709
WISCONSIN DHS
WI
Enumeration date
04/22/2020
Last updated
04/22/2020
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