EMERALD VALLEY ASSISTED LIVING, LLC (NPI# 1619182672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619182672 |
| Entity Type | Organization |
| Organization Name | EMERALD VALLEY ASSISTED LIVING, LLC |
| Practice Address |
200 W Valley Rd Appleton WI 54915-6263 |
| Practice Telephone | 9203785839 |
| Practice Fax Number | 9209687582 |
| Mailing Telephone | 9203785839 |
| Mailing Fax Number | 9209687582 |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. KATHERINE R. TEGEN (OWNER) |
| Authorized Official Telephone | 9203785839 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | WI | Nursing & Custodial Care Facilities |
| Street Address |
200 W VALLEY RD |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-6263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1427387661 | Province Terrace Villas Long Ct. LLC | Assisted Living Facility | 5216 Long Court, Appleton, WI 54914 | 2009-12-17 |
| 1467674507 | Fox River Assisted Living & Memory Care, LLC | Assisted Living Facility | 5800 Pennsylvania Ave, Appleton, WI 54914 | 2007-05-02 |
| 1346658473 | S-h Opco Fox River, LLC | Assisted Living Facility | 5800 Pennsylvania Ave, Appleton, WI 54914-7563 | 2014-08-01 |
| 1063764942 | Rennes Assisted Living Corp. | Assisted Living Facility | 301 E Florida Ave, Appleton, WI 54911-1325 | 2012-10-03 |
| 1275817306 | Emeritus Corporation | Assisted Living Facility | 5800 Pennsylvania Ave, Appleton, WI 54914-7557 | 2011-10-07 |
| 1417271628 | Carrington Manor Assisted Living of Green Bay, LLC | Assisted Living Facility | W3124 Van Roy Rd, Appleton, WI 54915-3982 | 2010-03-16 |
| 1538490438 | Carolina Manor Assisted Living of Appleton, LLC | Assisted Living Facility | W3124 Van Roy Rd, Appleton, WI 54915-3982 | 2010-01-18 |
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| 1326654534 | Praitie Assisted Living Inc. | Assisted Living Facility | 749 E Oshkosh St, Ripon, WI 54971-1258 | 2020-09-22 |
| 1295340016 | St. Elizabeth Manor, Inc. | Assisted Living Facility | 111 Commercial Dr, Footville, WI 53537 | 2020-09-09 |
| 1730793001 | Zinzendorf Hall, Inc. | Assisted Living Facility | 1047 Hill St, Watertown, WI 53098-3015 | 2020-09-03 |
| 1184236044 | Francine Carter | Assisted Living Facility | 4341 N 19th St, Milwaukee, WI 53209-6831 | 2020-08-20 |
| 1598377905 | Nohc Jackson Senior Living LLC | Assisted Living Facility | N16744 Eagle Drive, Jackson, WI 53037 | 2020-08-18 |
| 1003427766 | Nohc Magnolia Meadows LLC | Assisted Living Facility | 1480 N 7th St, Manitowoc, WI 54220-2012 | 2020-08-14 |
| 1922616580 | Rheuvonia Reed | Assisted Living Facility | 543 E Arbor Cir, Oak Creek, WI 53154-8528 | 2020-07-20 |
| 1912515073 | Baldwin Coh, LLC | Assisted Living Facility | 1880 4th Ave, Baldwin, WI 54002-5134 | 2020-07-15 |
| 1427666593 | Hudson Coh II, LLC | Assisted Living Facility | 805 Heggen St, Hudson, WI 54016-5005 | 2020-07-15 |
| 1366050429 | Hudson Coh, LLC | Assisted Living Facility | 1111 Heggen St, Hudson, WI 54016-9222 | 2020-07-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.