NPIMap

Organization Active NPI

Destani'S Child Medical Day Care Provider, Inc

  • Pediatric Skilled Nursing Facility
  • Milwaukee, WI
National Provider Identifier
1013275775
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
Legal business name
DESTANI'S CHILD MEDICAL DAY CARE PROVIDER, INC
Practice address
3062 N 58TH St
#1
Milwaukee, WI 53210-1545
Phone
(414) 217-2495
Fax
(414) 445-3893
NPI assigned
May 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Janice M Gorden, R.N.
Title
Administrator
Phone
(414) 217-2495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X Primary

Addresses

Primary practice location

3062 N 58TH St
#1
Milwaukee, WI 53210-1545

Mailing address

3062 N 58TH St
#1
Milwaukee, WI 53210-1545
Phone (414) 217-2495

National Provider Directory

National Provider Directory
Tax ID family
Destani'S Child Medical Day Care Provider Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1013275775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3062 N 58TH ST",
            "address_2": "#1",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101545",
            "telephone_number": "414-217-2495",
            "fax_number": "414-445-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 N 58TH ST",
            "address_2": "#1",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101545",
            "telephone_number": "414-217-2495",
            "fax_number": "414-445-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTANI'S CHILD MEDICAL DAY CARE PROVIDER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "GORDEN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-217-2495",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.