Healthcare Provider Details

I. General information

NPI: 1023190881
Provider Name (Legal Business Name): LINDENGROVE COMMUNITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W180N8071 TOWN HALL RD
MENOMONEE FALLS WI
53051-3518
US

IV. Provider business mailing address

1045 HILL ST
WATERTOWN WI
53098-3015
US

V. Phone/Fax

Practice location:
  • Phone: 262-253-2700
  • Fax: 262-253-2283
Mailing address:
  • Phone: 920-261-0400
  • Fax: 920-261-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2973
License Number StateWI

VIII. Authorized Official

Name: NICOLE CHWALA
Title or Position: CFO
Credential:
Phone: 920-206-4983