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Contact Information

LINCOLN LUTHERAN COMMUNITY CARE CORPORATION
6101 16TH STREET
RACINE, WI53406
 Phone: 262-637-7486
 Fax: 262-633-3045
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for LINCOLN LUTHERAN COMMUNITY CARE CORPORATION

NPI Number 1871677963
LBN Legal business name LINCOLN LUTHERAN COMMUNITY CARE CORPORATION
Authorized official FRED BOVA - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/25/2006
Last updated 02/16/2012 - About 14 years ago
Identifiers
WI License # 3179
WI Medicaid 20177300
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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