52D0888883 CLIA NUMBER - BEDROCK HCS AT GREENDALE

Laboratory Demographics

CLIA Number: 52D0888883

Facility Name: BEDROCK HCS AT GREENDALE

Facility Address:
5404 W LOOMIS RD
GREENDALE, WI
ZIP 53129
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Facility Phone Number: 414 421-0088

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1558912691

Taxonomy: 3140N1450X - Skilled Nursing Facility
A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.

CLIA Record

Field Name	Field Value
CLIA Number	52D0888883
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	BEDROCK HCS AT GREENDALE
Street	5404 W LOOMIS RD
City	GREENDALE
State	WI
ZIP	53129
Phone	414 421-0088
CertificateType	4
CertificateEffectiveDate	7/15/2022
CertificateExpirationDate	7/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024