Provider Demographics
NPI:1407308679
Name:NSH FLORENCE LLC
Entity Type:Organization
Organization Name:NSH FLORENCE LLC
Other - Org Name:FLORENCE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-962-5250
Mailing Address - Street 1:5150 N PORT WASHINGTON RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5474
Mailing Address - Country:US
Mailing Address - Phone:414-962-5250
Mailing Address - Fax:414-962-5251
Practice Address - Street 1:5778 CHAPIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:WI
Practice Address - Zip Code:54121-9443
Practice Address - Country:US
Practice Address - Phone:715-528-4833
Practice Address - Fax:715-528-4988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NSHC WISCONSIN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-03
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2909314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility