52D2193655 CLIA NUMBER - HOPE SENIOR LIVING, INC DBA HOPE SENIOR LIVING

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Laboratory Demographics

CLIA Number: 52D2193655

Facility Name: HOPE SENIOR LIVING, INC DBA HOPE SENIOR LIVING

Facility Address:
475 GROVE STREET
LOMIRA, WI
ZIP 53048
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Facility Phone Number: 920 269-7667

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1194930743

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	52D2193655
LAB Type	Assisted Living Facility
Facility Name	HOPE SENIOR LIVING, INC DBA HOPE SENIOR LIVING
Street	475 GROVE STREET
City	LOMIRA
State	WI
ZIP	53048
Phone	920 269-7667
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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