CHP Shorewood Wi Tenant Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0015905 Issued in WI

Legal business name

CHP SHOREWOOD WI TENANT CORP

Doing business as

HarborChase of Shorewood

Practice address

1111 E Capitol Dr
Shorewood, WI 53211-1810

Phone

(414) 436-0311

Fax

(414) 436-0312

NPI assigned

Nov 22, 2016

Organization subpart

No

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

Authorized official

Name

Thomas Mitchell

Title

Cfo of Manager

Phone

(772) 492-5002

Specialties & licenses 1

Addresses

Other names 1

• HarborChase of Shorewood Doing business as

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1164965257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 HIGHWAY A1A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329632310",
            "telephone_number": "772-492-5002",
            "fax_number": "772-492-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E CAPITOL DR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111810",
            "telephone_number": "414-436-0311",
            "fax_number": "414-436-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHP SHOREWOOD WI TENANT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO OF MANAGER",
        "authorized_official_telephone_number": "772-492-5002"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "0015905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HarborChase of Shorewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jackie Ceille, MSW
• Justin A. Chapman, D.C.
• Chicago Mind Solutions - Mke LLC
• Chicago Mind Solutions-Milwaukee S.C.
• Chiropractic Company - Shorewood (Chiropractic Company)
• Alexa Christensen
• Noel Anne Clark, MS CCC SLP
• Tayler Simone Clark, LCSW
• Robert Edward Coleman Jr., ND, LMT
• Salonda Coleman

• Assisted Living Facility in Shorewood, WI
• Providers in Shorewood, 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 Nov 22, 2016; 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.