BEAVER DAM AL OPERATIONS LLC
NPI 1790497907
Assisted Living Facility in Beaver Dam, WI
About Beaver Dam Al Operations Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEAVER DAM AL OPERATIONS LLC (NPI 1790497907) is a healthcare organization registered as an assisted living facility in Beaver Dam, Wisconsin and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through December 1, 2027, maintains a secondary practice location in Beaver Dam, and lists Anya Vistman, Gc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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 52D2175791
Beaver Dam Al Operations Mc, LLC Dba Charleston House Mc · Beaver Dam, WIOther Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BEAVER DAM, WI 53916
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 Al Operations LLC's NPI number?
The NPI number for Beaver Dam Al Operations LLC is 1790497907. It was assigned to this organization in the NPPES registry on December 19, 2022.
Where is Beaver Dam Al Operations LLC located?
Beaver Dam Al Operations LLC is located at 104 Fakes Ct, Beaver Dam, WI 53916. The listed phone number is (773) 825-3336.
What is Beaver Dam Al Operations LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Beaver Dam Al Operations LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D2175791) is associated with this NPI, valid through December 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Beaver Dam Al Operations LLC was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
