Provider Demographics
NPI:1922091149
Name:HAMILTON CARE CENTER, LLC
Entity Type:Organization
Organization Name:HAMILTON CARE CENTER, LLC
Other - Org Name:D/B/A ATRIUM POST ACUTE CARE OF TWO RIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-364-9754
Mailing Address - Street 1:1726 N BALLARD RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2444
Mailing Address - Country:US
Mailing Address - Phone:920-991-9072
Mailing Address - Fax:920-749-4021
Practice Address - Street 1:1 HAMILTON DR
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-2335
Practice Address - Country:US
Practice Address - Phone:920-793-2261
Practice Address - Fax:920-794-5934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2225314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20189300Medicaid
WI525664Medicare Oscar/Certification