Organization
BETHANY HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY S REICHENBACH (CEO)
(715) 942-1400
Entity
Organization
Contact information
Practice address
1226 BERLIN ST, WAUPACA, WI 54981-1991
(715) 258-5521
(715) 258-7051
Mailing address
1226 BERLIN ST, WAUPACA, WI 54981-1991
(715) 258-5521
(715) 258-7051
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
1874
WI
314000000X
Skilled Nursing Facility
Primary
963
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21054200
—
WI
Enumeration date
07/07/2005
Last updated
04/02/2025
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