St. Joseph Residence, Inc. - the Washington Center

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0011417 Issued in WI

Legal business name

ST. JOSEPH RESIDENCE, INC. - THE WASHINGTON CENTER

Practice address

500 W Washington St
New London, WI 54961-1971

Phone

(920) 982-5354

Fax

(920) 982-5420

NPI assigned

May 19, 2016

Last updated

May 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gidget Blank, NHA

Title

Executive Director / Ceo

Phone

(920) 982-5354

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1417304460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E BECKERT RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612509",
            "telephone_number": "920-982-5354",
            "fax_number": "920-982-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W WASHINGTON ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549611971",
            "telephone_number": "920-982-5354",
            "fax_number": "920-982-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH RESIDENCE, INC. - THE WASHINGTON CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "GIDGET",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR / CEO",
        "authorized_official_telephone_number": "920-982-5354",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0011417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Spiegelberg
• Mary Joann Spiller, NP
• Nicholas John Sprangers, PHARMD
• St Joseph Residence Inc
• Pamela J. St. Clair, P.T.
• Tiffany Strey, RN
• Sundance Services Corp (Genesis Rehab Services)
• Craig E Sylte, O.D.
• Mark Alan Tegtmeier, MA, LCSW, LPC, LMFT
• Marcella K Teske, APNP

• Assisted Living Facility in New London, WI
• Providers in New London, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.