Provider Demographics
NPI:1376889436
Name:CONSOLIDATED INVESTMENTS CORPORATION
Entity Type:Organization
Organization Name:CONSOLIDATED INVESTMENTS CORPORATION
Other - Org Name:POTTERS COUNTRY HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:SELCHOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-235-3529
Mailing Address - Street 1:N3426 STATE ROAD 25
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-6405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:N3430 STATE ROAD 25
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-6405
Practice Address - Country:US
Practice Address - Phone:715-235-3529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility