Healthcare Provider Details

I. General information

NPI: 1518178581
Provider Name (Legal Business Name): CEDAR SPRINGS HEALTH & REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N27W5707 LINCOLN BLVD
CEDARBURG WI
53012-2852
US

IV. Provider business mailing address

961 LAMPLIGHTER LN
GRAFTON WI
53024-9314
US

V. Phone/Fax

Practice location:
  • Phone: 262-376-7676
  • Fax: 262-376-5208
Mailing address:
  • Phone: 262-387-0023
  • Fax: 262-387-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number2103-026
License Number StateWI

VIII. Authorized Official

Name: MRS. DEBBIE KAY DLUGOPOLSKI
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR
Phone: 262-376-7676