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NPI Code Detail

MEDICARE: BENEVOLENT CORPORATION CEDAR COMMUNITY

MEDICARE: BENEVOLENT CORPORATION CEDAR COMMUNITY
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 Facility0705WI

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 : 1811997695
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENEVOLENT CORPORATION CEDAR COMMUNITY
Provider Business Mailing Address
First Line : 5595 COUNTY ROAD Z
Second Line :
City : WEST BEND
State : WI
Zip : 53095-9224
Country : US
Telephone Number : 262-306-2100
Fax Number : 262-306-2126
Provider Business Practice Location Address
First Line : 5595 COUNTY ROAD Z
Second Line :
City : WEST BEND
State : WI
Zip : 53095-9224
Country : US
Telephone Number : 262-306-2100
Fax Number : 262-306-2126
Authorized Official
Title or Position : VICE PRESIDENT OF FINANCE
Name : JOSEPH T PICHLER
Credential :
Telephone Number : 262-306-4212
Provider Enumeration Date : 07/22/2005
Last Update Date : 03/15/2021

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Directions to “BENEVOLENT CORPORATION CEDAR COMMUNITY ” Practice Location

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