Provider Demographics
NPI:1679225031
Name:A PLACE FOR US LLC
Entity Type:Organization
Organization Name:A PLACE FOR US LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:NINNEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:608-695-7734
Mailing Address - Street 1:35 TOWER DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1225
Mailing Address - Country:US
Mailing Address - Phone:608-856-4778
Mailing Address - Fax:608-541-2222
Practice Address - Street 1:35 TOWER DR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1225
Practice Address - Country:US
Practice Address - Phone:608-856-4778
Practice Address - Fax:608-541-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility