NPIMap

Organization Active NPI

Bethesda Lutheran Communities

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Watertown, WI
National Provider Identifier
1033429683
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
BETHESDA LUTHERAN COMMUNITIES
Practice address
600 Hoffmann Dr
Watertown, WI 53094-6223
Phone
(920) 261-3050
NPI assigned
Oct 18, 2010
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Schutte
Title
Director of Accounts Receivable
Phone
(920) 206-4486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

600 Hoffmann Dr
Watertown, WI 53094-6223

Mailing address

600 Hoffmann Dr
Watertown, WI 53094-6223
Phone (920) 261-3050

Other identifiers 1

IdentifierTypeStateIssuer
99533340MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Ablelight Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1033429683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOFFMANN DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946223",
            "telephone_number": "920-261-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOFFMANN DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946223",
            "telephone_number": "920-261-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA LUTHERAN COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "SCHUTTE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "920-206-4486",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99533340",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.