EDENBROOK MEADOWS ASSISTED LIVING LLC
NPI 1740922095
Assisted Living Facility in Fond Du Lac, WI
About Edenbrook Meadows Assisted Living Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDENBROOK MEADOWS ASSISTED LIVING LLC (NPI 1740922095) is a healthcare organization registered as an assisted living facility in Fond Du Lac, Wisconsin and active in the NPI registry since April 2022. The organization holds a CLIA Waiver certificate valid through February 6, 2028 and lists Maxim Stesel, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 52D2178746
Edenbrook Meadows Assisted Living, LLC · Fond Du Lac, WIFrequently 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 Edenbrook Meadows Assisted Living LLC's NPI number?
The NPI number for Edenbrook Meadows Assisted Living LLC is 1740922095. It was assigned to this organization in the NPPES registry on April 8, 2022.
Where is Edenbrook Meadows Assisted Living LLC located?
Edenbrook Meadows Assisted Living LLC is located at 154 S Pioneer Pkwy, Fond Du Lac, WI 54935. The listed phone number is (920) 921-3993.
What is Edenbrook Meadows Assisted Living LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Edenbrook Meadows Assisted Living LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D2178746) is associated with this NPI, valid through February 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Edenbrook Meadows Assisted Living LLC was last updated on April 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Edenbrook Meadows Assisted Living Llc · NPI 1740922095
Assisted Living Facility organization in Fond Du Lac, Wisconsin. Organization record, active in the CMS NPPES registry since April 8, 2022.
## Identity
- **NPI:** 1740922095 (Entity type: Organization)
- **Enumerated:** April 8, 2022
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Organization subpart:** No
- **Authorized official:** Maxim Stesel, MANAGER
## Practice location
- **Address:** 154 S PIONEER PKWY, Fond Du Lac, WI 54935-3848
- **Phone:** (920) 921-3993
## Record status
- **NPPES last updated:** April 8, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1740922095) · Data from the CMS NPPES public registry.