Northland Lutheran Home Health Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

256 Issued in WI

Legal business name

NORTHLAND LUTHERAN HOME HEALTH SERVICES, INC.

Practice address

925 Pine Beach Rd
Marinette, WI 54143-4227

Phone

(715) 735-6222

Fax

(715) 735-6221

NPI assigned

May 31, 2005

Organization subpart

No

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

Authorized official

Name

Gary Gustafson

Title

Director of Finance

Phone

(715) 732-0155

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1144223538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 PINE BEACH RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434227",
            "telephone_number": "715-735-6222",
            "fax_number": "715-735-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 PINE BEACH RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434227",
            "telephone_number": "715-735-6222",
            "fax_number": "715-735-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND LUTHERAN HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "715-732-0155"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2828102",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415-27500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Nicklaus, PHARM D, RPH
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• Home Health Agency in Marinette, WI
• Providers in Marinette, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.