Organization
ST PAUL ELDER SERVICES, INC
Active
Other names
ST PAUL ELDER SERVICES INC CLUB GABRIEL, St Paul Elder Services Adult Day Service
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN HERMAN (CFO)
(920) 766-6020
Entity
Organization
Contact information
Practice address
316 E 14TH ST, KAUKAUNA, WI 54130-3304
(920) 766-6020
(920) 766-9161
Mailing address
316 E 14TH ST, KAUKAUNA, WI 54130-3304
(920) 766-6020
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010491
ADULT DAY CARE CERTIFICATE
WI
Enumeration date
02/26/2021
Last updated
02/26/2021
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