Provider Demographics
NPI:1275413684
Name:CEDARBURG AL, LLC
Entity type:Organization
Organization Name:CEDARBURG AL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING PROJECT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:GABRIELE
Authorized Official - Last Name:LIMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-552-0109
Mailing Address - Street 1:600 3RD AVE FL 21
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1916
Mailing Address - Country:US
Mailing Address - Phone:646-314-4327
Mailing Address - Fax:
Practice Address - Street 1:W56N225 MCKINLEY BLVD
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2800
Practice Address - Country:US
Practice Address - Phone:262-376-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility