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ALEXIAN VILLAGE OF MILWAUKEE NPI 1144396300


NPI Information

NPI: 1144396300
Provider Name: ALEXIAN VILLAGE OF MILWAUKEE
Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 52D1057949

Address:
9255 N 76TH ST
MILWAUKEE, WI
ZIP 53223
Phone: (414) 355-9300
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ALEXIAN VILLAGE OF MILWAUKEE is a nursing facility intermediate care facility in Milwaukee, WI. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. ALEXIAN VILLAGE OF MILWAUKEE NPI is 1144396300. The provider is registered as an organization entity type.

The provider's business location address is:

9255 N 76TH ST
MILWAUKEE, WI
ZIP 53223-058
Phone: (414) 355-9300
Fax: (414) 357-5106

The provider's authorized official is Dewayne Mcmullin .
The authorized official title is Cfo, Senior Ministries and has the following contact phone number (314) 880-8941.

The CLIA number assigned to this NPI record is 52D1057949 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2006 and was last updated on 11/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1525523MEDICARE OSCAR/CERTIFICATION
220169500MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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