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General NPI Number Information
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NPI Number | 1184973588
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Entity Type | Organization
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Legal Business Name | NEWCASTLE SENIOR CARE, LLC
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 12600 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3469
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Country | US
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Telephone | 262-387-8800
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Fax | 262-387-8994
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Provider Business Mailing Address
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Address Line | 12600 N PORT WASHINGTON RD
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City | MEQUON
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State | WI
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Zip | 53092-3469
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Country | US
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Telephone | 262-387-8800
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Fax | 262-387-8994
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Authorized Official
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Title or Position | MANAGER OF MANAGING MEMBER
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Name | ROBERT W. CHAPIN
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Credential |
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Telephone | 407-999-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 0016286
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0016287
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 235
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License Number State | WI
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