MEDICAID
NPI 1336109776
Custodial Care Facility in Menasha, WI

Active since March 27, 2006
1125 GENEVA RD, MENASHA, WI 54952(920) 450-8323 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Medicaid NPPES

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

MEDICAID (NPI 1336109776) is a healthcare organization registered as a custodial care facility in Menasha, Wisconsin and active in the NPI registry since March 2006. The organization lists Lori Ann Farragh, Rn, as its authorized official.

NPPES Registry Identity

NPI1336109776
Entity TypeOrganization
Primary Taxonomy311Z00000X
Legal Business NameMEDICAID
Location Address1125 GENEVA RDMenasha, WI 54952-1505
Mailing Address1125 Geneva RdMenasha, WI 54952-1505 · (920) 450-8323
Organization SubpartNo
Authorized OfficialLori Ann FarraghRn · (920) 450-8323
Enumeration DateMarch 27, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPI 1336109776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCustodial Care FacilityNursing & Custodial Care Facilities
Taxonomy Code311Z00000X
Definition

A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.

1125 GENEVA RD, Menasha, WI 54952

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 Medicaid's NPI number?

The NPI number for Medicaid is 1336109776. It was assigned to this organization in the NPPES registry on March 27, 2006.

Where is Medicaid located?

Medicaid is located at 1125 Geneva Rd, Menasha, WI 54952. The listed phone number is (920) 450-8323.

What is Medicaid's specialty?

The primary specialty registered for this NPI is Custodial Care Facility with taxonomy code 311Z00000X.

When was this NPI record last updated?

The NPPES record for Medicaid was last updated on September 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.