Healthcare Provider Details

I. General information

NPI: 1457282246
Provider Name (Legal Business Name): LONG CHENG SENIOR CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 S LAWE ST
APPLETON WI
54915-2424
US

IV. Provider business mailing address

1804 S LAWE ST
APPLETON WI
54915-2424
US

V. Phone/Fax

Practice location:
  • Phone: 920-944-5630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA THOR
Title or Position: ADMIN STAFF
Credential:
Phone: 920-944-5630