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Organization

LINCOLN LUTHERAN HOME OF RACINE INC

Active
Other names
Lincoln Village Convalescent Center
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY GLEN APPLE (CHIEF FINANCIAL OFFICER)
(262) 898-2722
Entity
Organization

Contact information

Practice address
1700 CA BECKER DRIVE, RACINE, WI 53406
(262) 637-9751
(262) 633-3045
Mailing address
2000 DOMANIK DRIVE, RACINE, WI 53404
(262) 633-0500
(262) 633-3045

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2269
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20129400
WI
Enumeration date
10/25/2006
Last updated
08/22/2020
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