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Organization

HERITAGE ASSISTED LIVING OF WATERTOWN, LLC

Active
Parent organization
THE LUTHERAN HOME ASSOCIATION
Other names
Heritage Homes Assisted Living
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE LUTHERAN HOME ASSOCIATION
Authorized official
LAURIE REHM NHA (ADMINISTRATOR)
(920) 206-9448
Entity
Organization

Contact information

Practice address
700 WELSH RD, WATERTOWN, WI 53098-4266
(920) 206-9448
(920) 567-2038
Mailing address
700 WELSH RD, WATERTOWN, WI 53098-4266
(920) 206-9448
(920) 567-2038

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
0013392
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0013392
COMMUNITY-BASED RESIDENTIAL FACILITY LICENSE
WI
Enumeration date
12/20/2010
Last updated
12/20/2010
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