Organization Active NPI

Bruce Neenah Senior Living, Inc.

Doing business as Parkside Senior Living

  • Assisted Living Facility
  • Neenah, WI
National Provider Identifier
1376077073
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BRUCE NEENAH SENIOR LIVING, INC.
Doing business as
Parkside Senior Living
Practice address
2330 Bruce St
Neenah, WI 54956-4834
Phone
(920) 727-1120
Fax
(920) 727-1585
NPI assigned
Apr 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X WI Primary

Addresses

Primary practice location

2330 Bruce St
Neenah, WI 54956-4834

Mailing address

2330 Bruce St
Neenah, WI 54956-4834
Phone (920) 727-1120

Other names 1

  • Parkside Senior Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1026291Parkside Senior Living2330 Bruce St, Neenah, WI 54956Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1376077073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 BRUCE ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564834",
            "telephone_number": "920-727-1120",
            "fax_number": "920-727-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 BRUCE ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564834",
            "telephone_number": "920-727-1120",
            "fax_number": "920-727-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE NEENAH SENIOR LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.