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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:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
WINA-CBRF

Other Provider Identifiers:

IssuerNumberStateType
2013000WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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