Heritage Assisted Living of Watertown, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0013392 Issued in WI

Legal business name

HERITAGE ASSISTED LIVING OF WATERTOWN, LLC

Practice address

700 Welsh Rd
Watertown, WI 53098-4266

Phone

(920) 206-9448

Fax

(920) 567-2038

NPI assigned

Dec 20, 2010

Organization subpart

Yes

Parent organization

THE LUTHERAN HOME ASSOCIATIONAs reported in NPPES

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

Authorized official

Name

Laurie Rehm, NHA

Title

Administrator

Phone

(920) 206-9448

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Homes Assisted Living Doing business as

Part of

The Lutheran Home Cochrane

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1952604688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WELSH RD",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530984266",
            "telephone_number": "920-206-9448",
            "fax_number": "920-567-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WELSH RD",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530984266",
            "telephone_number": "920-206-9448",
            "fax_number": "920-567-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE ASSISTED LIVING OF WATERTOWN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LUTHERAN HOME ASSOCIATION",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "REHM",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-206-9448",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0013392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY-BASED RESIDENTIAL FACILITY LICENSE",
            "identifier": "0013392",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Homes Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Healthstat Onsite Clinic Watertown
• Hearing Center, Inc.
• Melanie Terese Heese, RN
• Robert Delano Heinen, MD
• Amber Rose Hendriksen, NP
• Shandell Lee Herrick, FNP-BC
• Desiree Monik Herron, O.D.
• Gwen Herzog, RN
• Catherine Hetzel
• Angela Hill, OTR

• Assisted Living Facility in Watertown, WI
• Providers in Watertown, 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 Dec 20, 2010; 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.