West Bend Ops, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0013625 Issued in WI

Legal business name

WEST BEND OPS, LLC

Doing business as

Lighthouse of West Bend

Practice address

2130 Continental Dr
West Bend, WI 53095-7904

Phone

(262) 338-0092

NPI assigned

Sep 28, 2012

Last updated

Mar 19, 2014By 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

Tina Duval

Title

Controller

Phone

(952) 241-8202

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse of West Bend Doing business as

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1962753020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 CONTINENTAL DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 CONTINENTAL DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957904",
            "telephone_number": "262-338-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BEND OPS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "952-241-8202"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0013625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse of West Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in West Bend, WI
• Providers in West Bend, 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 Mar 19, 2014; 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.