LARSON HOUSE PLATINUM LLC
NPI 1811517642
Assisted Living Facility in Columbus, WI

Active since April 22, 2020CLIA 52D1016891 · Waiver
550 RIVER RD, COLUMBUS, WI 53925(920) 623-5253(920) 623-5255 Get Directions Write a Review

NPPES record last updated: April 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Larson House Platinum Llc NPPES

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

LARSON HOUSE PLATINUM LLC (NPI 1811517642), doing business as Larson House, is a healthcare organization registered as an assisted living facility in Columbus, Wisconsin and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through January 20, 2027 and lists John Teresinski, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1811517642
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLARSON HOUSE PLATINUM LLC
Location Address550 RIVER RDColumbus, WI 53925-1721
Mailing Address2448 S 102nd St Ste 305West Allis, WI 53227-2141 · (414) 940-6608
Fax(920) 623-5255
Organization SubpartNo
Authorized OfficialJohn TeresinskiManaging Director · (414) 940-6608
Enumeration DateApril 22, 2020
NPPES CertifiedApril 22, 2020
NPI 1811517642 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.

550 RIVER RD, Columbus, WI 53925

Other Names 2

Doing Business AsLarson House
Doing Business AsLarson House South

Other Identifiers 2

Other0015679WI · Wisconsin Dhs
Other0016818WI · Wiscnsin Dhs

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 52D1016891

Larson House Platinum · Columbus, WI
Active · expires Jan 20, 2027
CLIA Number52D1016891
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 21, 2025
Certificate Expiration DateJanuary 20, 2027
Laboratory DirectorMs. Melissa Bloomhuff
Laboratory Phone(920) 623-5253
Laboratory LocationLarson House Platinum550 River Rd, Columbus, WI 53925
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Assisted Living Facility
550 RIVER RD
COLUMBUS, WI 53925

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811517642, enumerated as an "organization" on April 22, 2020.

The provider is located at 550 RIVER RD COLUMBUS, WI 53925 and the phone number is (920) 623-5253.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.