Provider Demographics
NPI:1740283225
Name:ELMWOOD NURSING HOME INC
Entity type:Organization
Organization Name:ELMWOOD NURSING HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-832-3003
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54702-0287
Mailing Address - Country:US
Mailing Address - Phone:715-832-3003
Mailing Address - Fax:715-832-3021
Practice Address - Street 1:232 SPRINGER AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD
Practice Address - State:WI
Practice Address - Zip Code:54740-8806
Practice Address - Country:US
Practice Address - Phone:715-639-2911
Practice Address - Fax:715-639-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2352314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20159400Medicaid
WI20159400Medicaid