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EMERALD RIDGE ASSISTED LIVING, LLC
NPI 1871876003
Assisted Living Facility in Neenah, WI

Active since September 23, 2011CLIA 52D0984739 · Waiver
130 BYRD AVE, NEENAH, WI 54956(920) 574-3833(920) 574-3850 Get Directions Write a Review

NPPES record last updated: May 20, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Emerald Ridge Assisted Living, Llc NPPES

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

EMERALD RIDGE ASSISTED LIVING, LLC (NPI 1871876003) is a healthcare organization registered as an assisted living facility in Neenah, Wisconsin and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through March 28, 2027 and lists Katherine R Tegen, Owner, as its authorized official.

NPPES Registry Identity

NPI1871876003
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEMERALD RIDGE ASSISTED LIVING, LLC
Location Address130 BYRD AVENeenah, WI 54956-4079
Mailing Address3232 N Ballard Rd, Suite 202Appleton, WI 54911-8804 · (920) 574-3833 · Fax (920) 574-3850
Phone(920) 574-3833
Fax(920) 574-3850
Organization SubpartNo
Authorized OfficialKatherine R TegenOwner · (920) 378-5839
Enumeration DateSeptember 23, 2011
Last NPPES UpdateMay 20, 2016
✔ NPI 1871876003 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.
130 BYRD AVE, Neenah, WI 54956
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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 52D0984739

Emerald Ridge Assisted Living, LLC · Neenah, WI
Active · expires Mar 28, 2027
CLIA Number52D0984739
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 29, 2025
Certificate Expiration DateMarch 28, 2027
Laboratory DirectorMs. Vicki S. Hanson
Laboratory Phone(920) 722-5100
Laboratory LocationEmerald Ridge Assisted Living, LLC130 Byrd Ave, Neenah, WI 54956
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Emerald Ridge Assisted Living, LLC's NPI number?

The NPI number for Emerald Ridge Assisted Living, LLC is 1871876003. It was assigned to this organization in the NPPES registry on September 23, 2011.

Where is Emerald Ridge Assisted Living, LLC located?

Emerald Ridge Assisted Living, LLC is located at 130 Byrd Ave, Neenah, WI 54956. The listed phone number is (920) 574-3833.

What is Emerald Ridge Assisted Living, LLC's specialty?

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

Does Emerald Ridge Assisted Living, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0984739) is associated with this NPI, valid through March 28, 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 Emerald Ridge Assisted Living, LLC was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.