Provider Demographics
NPI:1093068256
Name:ARCADIA NURSING HOME
Entity Type:Organization
Organization Name:ARCADIA NURSING HOME
Other - Org Name:CATHOLIC RESIDENTIAL SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:GAJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-784-5329
Mailing Address - Street 1:464 S SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:WI
Mailing Address - Zip Code:54612-1401
Mailing Address - Country:US
Mailing Address - Phone:608-323-3341
Mailing Address - Fax:608-323-3694
Practice Address - Street 1:464 S SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:WI
Practice Address - Zip Code:54612-1401
Practice Address - Country:US
Practice Address - Phone:608-323-3341
Practice Address - Fax:608-323-3694
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC RESIDENTIAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
525593Medicare Oscar/Certification