MEDICARE: APPLETON RETIREMENT OPCO 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1952256364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLETON RETIREMENT OPCO LLC

Provider Business Mailing Address
First Line	:	3520 E RIVER RD NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-5407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W PACKARD ST
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54911-6700
Country	:	US
Telephone Number	:	920-954-9990
Fax Number	:

Authorized Official
Title or Position	:	VP BUSINESS STRATEGY
Name	:	JORDAN RYAN
Credential	:
Telephone Number	:	507-251-6356

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “APPLETON RETIREMENT OPCO LLC ” Practice Location

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