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General NPI Number Information
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NPI Number | 1861557753
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Entity Type | Organization
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Legal Business Name | AURORA HEALTH CARE SOUTHERN LAKES, INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 252 MCHENRY ST
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City | BURLINGTON
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State | WI
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Zip | 53105
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Country | US
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Telephone | 262-763-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 252 MCHENRY ST
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City | BURLINGTON
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State | WI
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Zip | 53105-1828
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Country | US
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Telephone | 262-763-2411
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Fax |
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Authorized Official
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Title or Position | VP MANAGED HEALTH
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Name | KARA RICHARDSON
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Credential |
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Telephone | 704-631-0450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 14
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License Number State | WI
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