Organization
COUNTY OF OZAUKEE
Active
Other names
Lasata Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RALPH G LUEDTKE NH ADMINISTRATOR (NH ADMINISTRATOR)
(262) 512-2844
Entity
Organization
Contact information
Practice address
W76 N677 WAUWATOSA RD, CEDARBURG, WI 53012-1707
(262) 512-2844
(262) 377-4202
Mailing address
W76N677 WAUWATOSA RD, CEDARBURG, WI 53012-1707
(262) 377-5060
(262) 377-4203
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2361
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20129900
—
WI
Enumeration date
06/30/2005
Last updated
02/02/2023
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