METHODIST MANOR INC
Assisted Living Facility
West Allis, Wisconsin
Provider NPI: 1649247453
Organization Information:Organization Name: METHODIST MANOR INC
Practice Location:
3023 S 84TH ST WEST ALLIS, WI 53227 US
Tel: 414-607-4100 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
3023 S 84TH ST WEST ALLIS, WI 53227 US
Tel: 414-607-4100 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | WI | NA-CBRF |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2013000 | WI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin