OrganizationActive
Beaver Dam Al Operations LLC
NPI 1790497907 · Assisted Living Facility · Beaver Dam, WI
Provider details
- NPI number
- 1790497907
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Anya Vistman, Gc(773) 825-3336
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
104 Fakes Ct
Beaver Dam, WI 53916-2699
Phone: (773) 825-3336
Approximate (ZIP-level) locationGet directions
Mailing address
8170 Mccormick Blvd Ste 112
Skokie, IL 60076-2914
Additional practice locations (1)
- 129 Evergreen CirBeaver Dam, WI 53916-3512Phone: (773) 825-3336
Registry dates
- Enumerated
- 2022-12-19
- Last updated
- 2022-12-19
- Certified
- 2022-12-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.