Provider Demographics
NPI:1629152889
Name:WINONA SENIOR SERVICES, INC.
Entity Type:Organization
Organization Name:WINONA SENIOR SERVICES, INC.
Other - Org Name:WINONA AREA HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEISING-SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-457-4321
Mailing Address - Street 1:855 MANKATO AVE
Mailing Address - Street 2:PO BOX 5600
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-4868
Mailing Address - Country:US
Mailing Address - Phone:507-457-4468
Mailing Address - Fax:507-457-4413
Practice Address - Street 1:175 E WABASHA ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3492
Practice Address - Country:US
Practice Address - Phone:507-457-4468
Practice Address - Fax:507-457-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN333765251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4470133Medicaid
MN241535Medicare Oscar/Certification