=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093786543
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ST PAUL ELDER SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2006
-----------------------------------------------------
Last Update Date | 06/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 316 E 14TH ST
-----------------------------------------------------
City | KAUKAUNA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54130-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-766-6020
-----------------------------------------------------
Fax | 920-766-9161
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 316 E 14TH ST
-----------------------------------------------------
City | KAUKAUNA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54130-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-766-6020
-----------------------------------------------------
Fax | 920-766-9161
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | AMBER SCHROEDER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 920-766-6020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225CA2500X
-----------------------------------------------------
Taxonomy Name | Assistive Technology Supplier Rehabilitation Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2279E1000X
-----------------------------------------------------
Taxonomy Name | Educational Registered Respiratory Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 333300000X
-----------------------------------------------------
Taxonomy Name | Emergency Response System Companies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 2988
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------