MEDICARE: BISKOBING ENTERPRISES, INC.

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1306095377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BISKOBING ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	1207 FIRETHORN DR
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53090-5443
Country	:	US
Telephone Number	:	262-335-3789
Fax Number	:	262-335-3789

Provider Business Practice Location Address
First Line	:	1205 FIRETHORN DR
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53090-5443
Country	:	US
Telephone Number	:	262-751-3789
Fax Number	:	262-335-3789

Authorized Official
Title or Position	:	PRESIDENT / PROGRAM COORDINATOR
Name	:	MS. NANCY ANN BISKOBING
Credential	:	L.P.N.
Telephone Number	:	262-335-3789

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	09/15/2008

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