Organization
GOLDEN HARBOR, LLC
Active
Other names
Golden Harbor
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TERESINSKI (MANAGING DIRECTOR)
(414) 940-6608
Entity
Organization
Contact information
Practice address
505 S WATER ST, SHEBOYGAN, WI 53081-4429
(262) 470-5388
Mailing address
2448 S 102ND ST STE 305, WEST ALLIS, WI 53227-2141
(414) 940-6608
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013780
WISCONSIN DHS
WI
Enumeration date
07/03/2011
Last updated
04/27/2020
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