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SHOREHAVEN TOWER ASSISTED LIVING
NPI 1730579772
Assisted Living Facility in Oconomowoc, WI

Active since January 29, 2015CLIA 52D0674743 · Waiver
1305 W WISCONSIN AVE, OCONOMOWOC, WI 53066(262) 567-8341(262) 567-0273 Get Directions Write a Review

NPPES record last updated: January 29, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shorehaven Tower Assisted Living NPPES

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

SHOREHAVEN TOWER ASSISTED LIVING (NPI 1730579772) is a healthcare organization registered as an assisted living facility in Oconomowoc, Wisconsin and active in the NPI registry since January 2015. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Lorna Gartzke, Administrator, as its authorized official.

NPPES Registry Identity

NPI1730579772
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLUTHERAN HOMES OF OCONOMOWOC
Location Address1305 W WISCONSIN AVEOconomowoc, WI 53066-2646
Mailing Address1305 W Wisconsin AveOconomowoc, WI 53066-2646 · (262) 567-8341 · Fax (262) 567-0273
Phone(262) 567-8341
Fax(262) 567-0273
Organization SubpartNo
Authorized OfficialLorna GartzkeAdministrator · (262) 560-6922
Enumeration DateJanuary 29, 2015
✔ NPI 1730579772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
1305 W WISCONSIN AVE, Oconomowoc, WI 53066
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Other Names 1

Doing Business AsShorehaven Tower Assisted Living

Other Identifiers 2

Other52-5560WI · Ptan
Medicaid20152300WI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0674743

Lutheran Homes Of Oconomowoc · Oconomowoc, WI
Active · expires Aug 31, 2026
CLIA Number52D0674743
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. William Cooper
Laboratory Phone(262) 567-8341
Laboratory LocationLutheran Homes Of Oconomowoc1305-1311 W Wisconsin Ave (po Box 208), Oconomowoc, WI 53066
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

LUTHERAN HOMES OF OCONOMOWOC INC.
Skilled Nursing Facility
1305 W WISCONSIN AVE
OCONOMOWOC, WI 53066
Waukesha County (262) 560-6964
PAIGE CAVERS OTD, OTR/L
Occupational Therapist
1305 W WISCONSIN AVE
OCONOMOWOC, WI 53066
Waukesha County (262) 560-6910

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 Lutheran Homes Of Oconomowoc's NPI number?

The NPI number for Lutheran Homes Of Oconomowoc is 1730579772. It was assigned to this organization in the NPPES registry on January 29, 2015. The provider is doing business as Shorehaven Tower Assisted Living.

Where is Lutheran Homes Of Oconomowoc located?

Lutheran Homes Of Oconomowoc is located at 1305 W Wisconsin Ave, Oconomowoc, WI 53066. The listed phone number is (262) 567-8341.

What is Lutheran Homes Of Oconomowoc's specialty?

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

Does Lutheran Homes Of Oconomowoc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0674743) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lutheran Homes Of Oconomowoc was last updated on January 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.