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BEAVER DAM ASSISTED LIVING AND MEMORY CARE
NPI 1265090559
Assisted Living Facility in Beaver Dam, WI

Active since May 31, 2019
104 FAKES CT, BEAVER DAM, WI 53916(920) 356-9818 Get Directions Write a Review

NPPES record last updated: July 3, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 3, 2020, May 31, 2019 (2 updates tracked since 2019).

About Beaver Dam Assisted Living And Memory Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEAVER DAM ASSISTED LIVING AND MEMORY CARE (NPI 1265090559) is a healthcare organization registered as an assisted living facility in Beaver Dam, Wisconsin and active in the NPI registry since May 2019. The organization maintains a secondary practice location in Beaver Dam and lists Barbara Ann Bittner, Coo, as its authorized official.

NPPES Registry Identity

NPI1265090559
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBEAVER DAM ASSISTED LIVING, LLC
Location Address104 FAKES CTBeaver Dam, WI 53916-2699
Mailing Address5555 W Grande Market Dr Ste AAppleton, WI 54913-8170 · (920) 574-3833 · Fax (920) 574-3850
Phone(920) 356-9818
Organization SubpartNo
Authorized OfficialBarbara Ann BittnerCoo · (920) 378-1913
Enumeration DateMay 31, 2019
Last NPPES UpdateJuly 3, 20202 updates tracked since enumeration
NPPES CertifiedJuly 3, 2020
✔ NPI 1265090559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X
104 FAKES CT, Beaver Dam, WI 53916
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Other Names 1

Doing Business AsBeaver Dam Assisted Living And Memory Care

Secondary Practice Location 1

Location 1129 Evergreen CirBeaver Dam, WI 53916-3512 · Phone (920) 356-9818

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ADAM ALTENBURG
Physical Therapy Assistant
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (920) 356-9818
POWERBACK REHABILITATION LLC
Clinic/Center (Rehabilitation)
104 FAKES CT, C/O LANDMARK AT CHARLESTON HOUSE
BEAVER DAM, WI 53916
Dodge County (610) 925-4560
NICK GAFFNEY PTA
Physical Therapy Assistant
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (920) 356-9818
MRS. KIM MARIE VANDER GALIEN COTA
Occupational Therapy Assistant
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (920) 219-4941
BEAVER DAM AL OPERATIONS LLC
Assisted Living Facility
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (773) 825-3336
LIBERTY SIEBRECHT
Speech-Language Pathologist
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (920) 356-9818
AMY E NEUBECKER M.S. SLP-CCC
Speech-Language Pathologist
104 FAKES CT
BEAVER DAM, WI 53916
Dodge County (920) 392-5122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beaver Dam Assisted Living, LLC's NPI number?

The NPI number for Beaver Dam Assisted Living, LLC is 1265090559. It was assigned to this organization in the NPPES registry on May 31, 2019. The provider is doing business as Beaver Dam Assisted Living And Memory Care.

Where is Beaver Dam Assisted Living, LLC located?

Beaver Dam Assisted Living, LLC is located at 104 Fakes Ct, Beaver Dam, WI 53916. The listed phone number is (920) 356-9818.

What is Beaver Dam Assisted Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Beaver Dam Assisted Living, LLC was last updated on July 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.