NPI 1427387661

Province Terrace Villas Long CT. LLC

Organisation Assisted Living Facility Appleton, WI

Practice location

Address: 5216 Long Court, Appleton, WI 54914
Phone: (920) 257-2573
Fax: (920) 882-0295
Mailing address: 5216 Long CT, Appleton, WI 54914-9111

Authorised official

Name: Roxanne Maria Reeves
Title: Administrator
Phone: (920) 257-2573

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 0012777 (WI)

Other Assisted Living Facility providers in Wisconsin →

Registry record

NPI: 1427387661
Entity type: Organization
NPI issued: 17 Dec 2009
Record last updated: 17 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.