MEDICARE: LINDENGROVE COMMUNITIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	5002	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003998790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDENGROVE COMMUNITIES LLC

Provider Business Mailing Address
First Line	:	1045 HILL ST
Second Line	:
City	:	WATERTOWN
State	:	WI
Zip	:	53098-3015
Country	:	US
Telephone Number	:	920-261-0400
Fax Number	:	920-261-4840

Provider Business Practice Location Address
First Line	:	837 E VETERANS WAY
Second Line	:
City	:	MUKWONAGO
State	:	WI
Zip	:	53149-1013
Country	:	US
Telephone Number	:	262-363-6830
Fax Number	:	262-363-6837

Authorized Official
Title or Position	:	CFO
Name	:	JULIE ANNE MARKS
Credential	:
Telephone Number	:	920-261-6235

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	06/30/2026

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Directions to “LINDENGROVE COMMUNITIES LLC ” Practice Location

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