Beaver Dam Al Operations LLC
NPI #1790497907 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1790497907
- Entity Type
- Organization
- Organization Name
- Beaver Dam Al Operations LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Dec 19, 2022
- Last Updated
- Dec 19, 2022
Practice Location
- Address
- 104 FAKES CT
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-2699
- Phone
- (773) 825-3336
Authorized Official
- Name
- ANYA VISTMAN
- Title
- GC
- Phone
- (773) 825-3336
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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