Provider Demographics
NPI:1033102983
Name:BETHANY-ST JOSEPH CORPORATION
Entity Type:Organization
Organization Name:BETHANY-ST JOSEPH CORPORATION
Other - Org Name:ONALASKA CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL SERVICES DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-788-5700
Mailing Address - Street 1:1600 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-2838
Mailing Address - Country:US
Mailing Address - Phone:608-783-4681
Mailing Address - Fax:608-781-8148
Practice Address - Street 1:1600 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-2838
Practice Address - Country:US
Practice Address - Phone:608-783-4681
Practice Address - Fax:608-781-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3160314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20184700Medicaid
WI20184700Medicaid