Peabody Manor

LBN: Thedacare, Incorporated
Peabody Manor is an health care organization with primary practice located at 2600 S Heritage Woods Dr , Appleton WI 54915-1408. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Thedacare, Incorporated can be contacted via phone (920) 738-3000, or through Flett, William via phone (920) 454-4013.

Contact Information

Primary practice address
2600 S Heritage Woods Dr Appleton WI 54915-1408
Phone: (920) 738-3000
Fax: (920) 225-7791
Website:
Map and Directions
Authorized official contact:
Name: Flett, William
Phone: (920) 454-4013

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 2622 Wisconsin

Profile Details

NPI number 1326079757
LBN Legal business name Thedacare, Incorporated
DBA Doing business as Peabody Manor
Authorized official Flett, William
Entity Organization
Organization subpart 1 No
Enumeration date Jul 5th, 2006
Last updated Jan 2nd, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326079757 NPPES
Wisconsin MEDICAID 20188400

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