Organization
AMERICAN LUTHERAN CHURCH-NORTHLAND LUTHERN SERVICES FOR THE ELDERLY, I
Active
Other names
Luther Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY GUSTAFSON (DIRECTOR OF FINANCE)
(715) 732-0155
Entity
Organization
Contact information
Practice address
831 PINE BEACH RD, MARINETTE, WI 54143-4225
(715) 732-0155
(715) 732-5899
Mailing address
831 PINE BEACH RD, MARINETTE, WI 54143-4225
(715) 732-0155
(715) 732-5595
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2155
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20126700
—
WI
Enumeration date
05/31/2005
Last updated
08/22/2016
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