Mission Creek Senior Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MISSION CREEK SENIOR CARE LLC

Practice address

3217 Fiddlers Creek Dr
Waukesha, WI 53188-3946

Phone

(262) 832-1020

NPI assigned

Mar 14, 2021

Organization subpart

No

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

Authorized official

Name

Anya Vistman

Title

Counsel

Phone

(773) 819-2190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615680000000",
    "number": "1144805847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-819-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 FIDDLERS CREEK DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883946",
            "telephone_number": "262-832-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CREEK SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A",
        "authorized_official_last_name": "VISTMAN",
        "authorized_official_first_name": "ANYA",
        "authorized_official_title_or_position": "COUNSEL",
        "authorized_official_telephone_number": "773-819-2190"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Minnich
• Elizabeth Claire Mintner
• Catherine M Miosi, RD
• Patricia Mary Mireles, MSW
• Renee Louise Miser, OTR
• Andrew B Mitchel, LPC
• Christine Marie Mitchel, MA, LPC
• Mary C Mitchell
• Neil Mitchell, LPC-IT
• Patricia Diane Mitchell, RN

• Assisted Living Facility in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2021; 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.