NPI 1851990436

Bv/Mstar Caledonia Tenant, LLC

Organisation Alzheimer Center (Dementia Center) Racine, WI

Practice location

Address: 5737 Erie St, Racine, WI 53402-1970
Phone: (262) 639-6025
Fax: (262) 639-5279

Authorised official

Name: Henry James Vaughn
Title: Reimbursement Analyst
Phone: (240) 595-6025

Registered specialties

Alzheimer Center (Dementia Center) Primary

Nursing & Custodial Care Facilities Taxonomy 311500000X

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Registry record

NPI: 1851990436
Entity type: Organization
NPI issued: 23 Oct 2020
Record last updated: 23 Oct 2020

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.