Bekus Adult Day Program LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

0015861 Issued in WI

Legal business name

BEKUS ADULT DAY PROGRAM LLC

Practice address

4425 N 63Rd St
Milwaukee, WI 53218-5548

Phone

(414) 366-7309

NPI assigned

Dec 31, 2016

Last updated

Dec 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Etta Dean Robertson

Title

Owner

Phone

(414) 366-7309

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1483142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483142400000",
    "number": "1437694338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N 63RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532185548",
            "telephone_number": "414-366-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 N 63RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532185548",
            "telephone_number": "414-366-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEKUS ADULT DAY PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-31",
        "last_updated": "2016-12-31",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "ETTA",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-366-7309"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "WI",
            "license": "0015861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.