Healthcare Provider Details

I. General information

NPI: 1093786543
Provider Name (Legal Business Name): ST PAUL ELDER SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 E 14TH ST
KAUKAUNA WI
54130-3304
US

IV. Provider business mailing address

316 E 14TH ST
KAUKAUNA WI
54130-3304
US

V. Phone/Fax

Practice location:
  • Phone: 920-766-6020
  • Fax: 920-766-9161
Mailing address:
  • Phone: 920-766-6020
  • Fax: 920-766-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225CA2500X
TaxonomyAssistive Technology Supplier Rehabilitation Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2279E1000X
TaxonomyEducational Registered Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2988
License Number StateWI

VIII. Authorized Official

Name: AMBER SCHROEDER
Title or Position: CFO
Credential:
Phone: 920-766-6020