| NPI | 1962753020 |
|---|---|
| Doing Business As | LIGHTHOUSE OF WEST BEND |
| Entity Type | Organization |
| Authorized Contact | TINA DUVAL Controller 952-241-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: WI 0013625) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2014-03-19 |