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NPI Code Detail

MEDICARE: SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH

MEDICARE: SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH
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
1314000000XSkilled Nursing Facility0624WI

Other Identifiers

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

General Provider Information

NPI Number : 1598766784
Entity Type Code : Organization
Provider Name (Legal Business Name) : SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH
Provider Business Mailing Address
First Line : 1045 HILL ST
Second Line :
City : WATERTOWN
State : WI
Zip : 53098-3015
Country : US
Telephone Number : 920-206-4983
Fax Number : 920-261-4840
Provider Business Practice Location Address
First Line : 109 S ATWOOD AVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53545-4098
Country : US
Telephone Number : 608-752-6709
Fax Number :
Authorized Official
Title or Position : CFO
Name : MS. JULIE MARKS
Credential :
Telephone Number : 920-206-4983
Provider Enumeration Date : 08/10/2005
Last Update Date : 10/14/2025

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Directions to “SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.