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NPI Code Detail

MEDICARE: NEWCASTLE PLACE, INC.

MEDICARE: NEWCASTLE PLACE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility1999WI
2314000000XSkilled Nursing Facility235WI

General Provider Information

NPI Number : 1093799272
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEWCASTLE PLACE, INC.
Provider Business Mailing Address
First Line : 12600 N PORT WASHINGTON RD
Second Line : #100
City : MEQUON
State : WI
Zip : 53092-3469
Country : US
Telephone Number : 262-387-8801
Fax Number : 262-387-8894
Provider Business Practice Location Address
First Line : 12600 N PORT WASHINGTON RD
Second Line : #100
City : MEQUON
State : WI
Zip : 53092-3469
Country : US
Telephone Number : 262-387-8801
Fax Number : 262-387-8894
Authorized Official
Title or Position : ADMINISTRATOR - COO
Name : MARJORIE GOZDOWIAK
Credential : ADMIN, COO
Telephone Number : 262-387-8801
Provider Enumeration Date : 12/01/2005
Last Update Date : 09/11/2025

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