52D0984739 CLIA NUMBER - EMERALD RIDGE ASSISTED LIVING, LLC

Laboratory Demographics

CLIA Number: 52D0984739

Facility Name: EMERALD RIDGE ASSISTED LIVING, LLC

Facility Address:
130 BYRD AVE
NEENAH, WI
ZIP 54956
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Facility Phone Number: 920 722-5100

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1871876003

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	52D0984739
LAB Type	Assisted Living Facility
Facility Name	EMERALD RIDGE ASSISTED LIVING, LLC
Street	130 BYRD AVE
City	NEENAH
State	WI
ZIP	54956
Phone	920 722-5100
CertificateType	4
CertificateEffectiveDate	3/29/2023
CertificateExpirationDate	3/28/2025
FacilityType	Waiver

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