Arizconsin Group Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2945 Issued in WI

Legal business name

ARIZCONSIN GROUP INC

Doing business as

Crandon Nursing Home

Practice address

105 W Pioneer St
Crandon, WI 54520-1554

Phone

(715) 478-3324

Fax

(715) 478-5085

NPI assigned

Jul 29, 2005

Last updated

Aug 8, 2007By 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

Mrs. Pamela I Rau

Title

Administrator

Phone

(715) 478-3324

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Crandon Nursing Home Doing business as

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1609876655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545200400",
            "telephone_number": "715-478-3324",
            "fax_number": "715-478-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W PIONEER ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201554",
            "telephone_number": "715-478-3324",
            "fax_number": "715-478-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZCONSIN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "RAU",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-478-3324",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20124900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACIOLITY LICENSE NUMBER",
            "identifier": "2945",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crandon Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alicia's Place
• Coleen Asbach
• Abigail B Ashbeck, LCSW
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. (Aspirus Crandon Clinic)
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. (Aspirus Crandon Clinic)
• Diane M Baird, LICENSED PROFESSIONA

• Skilled Nursing Facility in Crandon, WI
• Providers in Crandon, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.