Healthcare Provider Details

I. General information

NPI: 1386218105
Provider Name (Legal Business Name): NEWCASTLE PLACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 05/17/2021
Certification Date: 05/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 N PORT WASHINGTON RD
MEQUON WI
53092-3469
US

IV. Provider business mailing address

4201 CORPORATE DR
WEST DES MOINES IA
50266-5906
US

V. Phone/Fax

Practice location:
  • Phone: 262-387-8850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS HARSHFIELD
Title or Position: CFO
Credential:
Phone: 515-288-5805