Provider Demographics
NPI:1922482157
Name:DENMARK SENIOR LIVING, INC.
Entity Type:Organization
Organization Name:DENMARK SENIOR LIVING, INC.
Other - Org Name:SCANDINAVIAN COURT ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:346 SCANDINAVIAN CT
Mailing Address - Street 2:
Mailing Address - City:DENMARK
Mailing Address - State:WI
Mailing Address - Zip Code:54208-8908
Mailing Address - Country:US
Mailing Address - Phone:920-863-5362
Mailing Address - Fax:920-863-3942
Practice Address - Street 1:346 SCANDINAVIAN CT
Practice Address - Street 2:
Practice Address - City:DENMARK
Practice Address - State:WI
Practice Address - Zip Code:54208-8908
Practice Address - Country:US
Practice Address - Phone:920-863-5362
Practice Address - Fax:920-863-3942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility