Maryann Adult Family Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARYANN ADULT FAMILY HOME LLC

Practice address

3008 W Carmen Ave
Milwaukee, WI 53209-4235

Phone

(414) 640-1042

NPI assigned

Dec 13, 2019

Organization subpart

No

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

Authorized official

Name

Chiquita Lewis

Title

Owner

Phone

(414) 640-1042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1215575907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101010",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532107010",
            "telephone_number": "414-640-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094235",
            "telephone_number": "414-640-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYANN ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "CHIQUITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-640-1042"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Maruska, MD
• Marvin
• Brittany Marweg
• Mary Determan MSW, LLC
• Mary T Breger MDSC
• Marys Adult Family Services LLC
• Sara Marzinski, DNP, RN, AGCNS-BC
• Maria Mas, MD
• Kimiyo M Masaka, APNP
• Lauren H. Mascari, PHD, LP, NCC

• Assisted Living Facility in Milwaukee, WI
• Providers in Milwaukee, 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 Dec 13, 2019; 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.