Provider Demographics
NPI:1942320056
Name:GALLINA HEALTH CARE NETWORK, LTD
Entity Type:Organization
Organization Name:GALLINA HEALTH CARE NETWORK, LTD
Other - Org Name:TIMBER OAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KURANZ
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:262-878-2788
Mailing Address - Street 1:1390 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-1063
Mailing Address - Country:US
Mailing Address - Phone:262-878-4899
Mailing Address - Fax:262-878-1167
Practice Address - Street 1:1390 8TH AVE
Practice Address - Street 2:
Practice Address - City:UNION GROVE
Practice Address - State:WI
Practice Address - Zip Code:53182-1063
Practice Address - Country:US
Practice Address - Phone:262-878-4899
Practice Address - Fax:262-878-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI310564310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility