Provider Demographics
NPI:1992538763
Name:DIMENSIONS LIVING APPLETON, LLC
Entity type:Organization
Organization Name:DIMENSIONS LIVING APPLETON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGOTZKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-537-5700
Mailing Address - Street 1:12900 WHITEWATER DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9407
Mailing Address - Country:US
Mailing Address - Phone:763-210-6731
Mailing Address - Fax:763-210-6731
Practice Address - Street 1:5800 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-7563
Practice Address - Country:US
Practice Address - Phone:920-997-0725
Practice Address - Fax:920-734-7357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility