Provider Demographics
NPI:1912156530
Name:GRACE LUTHERAN FOUNDATION, INC.
Entity Type:Organization
Organization Name:GRACE LUTHERAN FOUNDATION, INC.
Other - Org Name:GRACE ADULT DAY SERVICES - ALTOONA
Other - Org Type:Doing Business As
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 1:2441 NEW PINE DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-3300
Practice Address - Country:US
Practice Address - Phone:715-832-8811
Practice Address - Fax:715-838-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care