Provider Demographics
NPI:1013695790
Name:COTTAGES WI LLC
Entity type:Organization
Organization Name:COTTAGES WI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-378-1913
Mailing Address - Street 1:51 PARK PL STE 100
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-8275
Mailing Address - Country:US
Mailing Address - Phone:920-378-5839
Mailing Address - Fax:
Practice Address - Street 1:3201 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-1131
Practice Address - Country:US
Practice Address - Phone:920-738-0118
Practice Address - Fax:920-738-0641
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COTTAGES WI LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility