Lutheran Homes of Oconomowoc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LUTHERAN HOMES OF OCONOMOWOC

Doing business as

Shorehaven Tower Assisted Living

Practice address

1305 W Wisconsin Ave
Oconomowoc, WI 53066-2646

Phone

(262) 567-8341

Fax

(262) 567-0273

NPI assigned

Jan 29, 2015

Organization subpart

No

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

Authorized official

Name

Lorna Gartzke

Title

Administrator

Phone

(262) 560-6922

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Shorehaven Tower Assisted Living Doing business as

Tax ID family

Lutheran Homes of Oconomowoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lutheran Homes of Oconomowoc Inc.

  • Skilled Nursing Facility
  • Oconomowoc, WI
  • NPI 1508852708
  NPD tax ID

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1730579772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W WISCONSIN AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530662646",
            "telephone_number": "262-567-8341",
            "fax_number": "262-567-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W WISCONSIN AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530662646",
            "telephone_number": "262-567-8341",
            "fax_number": "262-567-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOMES OF OCONOMOWOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "GARTZKE",
        "authorized_official_first_name": "LORNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-560-6922"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20152300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "52-5560",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shorehaven Tower Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brett A. Linzer, M.D.
• William G. Longe, D.D.S.
• LTDK LLC
• Paula R Lukas, PHARMD
• Philip Lewis Lutgen, R.PH.
• Lutheran Homes of Oconomowoc Inc.
• Nicholas Edward Mahoney
• Alicia Therese Malak, DDS
• Gabriela Almeida Maloney, DO
• Caley Deloris Mamerow, LPC

• Assisted Living Facility in Oconomowoc, WI
• Providers in Oconomowoc, 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 Jan 29, 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.