Organization
EMERALD SHORES ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE RAE TEGEN (OWNER)
(920) 378-5839
Entity
Organization
Contact information
Practice address
1100 BAUMEISTER DR, KEWAUNEE, WI 54216-1646
(920) 388-2833
(920) 388-2891
Mailing address
PO BOX 98, STOCKBRIDGE, WI 53088-0098
(920) 388-2833
(920) 388-2891
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
WI
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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