Healthcare Provider Details

I. General information

NPI: 1215142625
Provider Name (Legal Business Name): WINONA SENIOR SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 MANKATO AVE
WINONA MN
55987-5362
US

IV. Provider business mailing address

885 MANKATO AVE
WINONA MN
55987-5362
US

V. Phone/Fax

Practice location:
  • Phone: 507-454-0179
  • Fax:
Mailing address:
  • Phone: 507-454-0179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number333578
License Number StateMN

VIII. Authorized Official

Name: RACHELLE HEISING-SCHULTZ
Title or Position: CEO
Credential:
Phone: 507-454-3650