OrganizationActive
Beaver Dam Assisted Living, LLC
NPI 1265090559 · Assisted Living Facility · Beaver Dam, WI
Provider details
- NPI number
- 1265090559
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Barbara Bittner, Coo(920) 378-1913
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Alzheimer Center (Dementia Center)311500000X
Nursing & Custodial Care Facilities
Practice location
104 Fakes Ct
Beaver Dam, WI 53916-2699
Phone: (920) 356-9818
Approximate (ZIP-level) locationGet directions
Mailing address
5555 W Grande Market Dr Ste a
Appleton, WI 54913-8170
Other names (DBA / former)
- Doing business as
- Beaver Dam Assisted Living and Memory Care
- Doing business as
- Beaver Dam Assisted Living and Memory Care
Additional practice locations (1)
- 129 Evergreen CirBeaver Dam, WI 53916-3512Phone: (920) 356-9818
Registry dates
- Enumerated
- 2019-05-31
- Last updated
- 2020-07-03
- Certified
- 2020-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.