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Contact Information

ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC
33 EVERETT ST
FOND DU LAC, WI54935
 Phone: 920-926-7980
 Fax: 920-923-7995
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Assisted Living Facility

310400000X
Indicates primary specialty

NPI Profile & details for ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC

NPI # 1548259807
LBN Legal business name ST. FRANCIS HOME OF FOND DU LAC WISCONSIN, INC
Authorized official DOUGLAS TROST - (CEO/ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/19/2005
Last updated 08/23/2018 - About 8 years ago
Identifiers
WI License # 10373
WI License # 2561
WI Medicaid 20158100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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