Healthcare Provider Details

I. General information

NPI: 1679494736
Provider Name (Legal Business Name): CATALINAS HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12129 43RD AVE
PLEASANT PRAIRIE WI
53158-3925
US

IV. Provider business mailing address

12129 43RD AVE
PLEASANT PRAIRIE WI
53158-3925
US

V. Phone/Fax

Practice location:
  • Phone: 952-465-7126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CATALINA MARTINEZ
Title or Position: OWNER
Credential:
Phone: 952-465-7126