National Provider Identifier Database

MEDICAID
Custodial Care Facility

A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.


Contact Information

MEDICAID
1125 GENEVA RD
MENASHA, WI54952-1505
Phone: 920-450-8323
Fax:
Website:
Specialty Taxonomy Code
* Custodial Care Facility 311Z00000X
Nursing Care, Pediatric 3140N1450X

* Indicates primary specialty

NPI Profile & details for MEDICAID

NPI Number 1336109776
Legal business name
LBN
MEDICAID
Authorized official LORI FARRAGH - (RN)
Entity Organization
Organization subpart No
Enumeration date 03/27/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MEDICAID

There are currently no reviews for MEDICAID


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