NPIMap

Organization Active NPI

St Aemilian Lakeside Inc

  • Foster Care Agency
  • Milwaukee, WI
National Provider Identifier
1609043165
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
6949-123 Issued in WI
Legal business name
ST AEMILIAN LAKESIDE INC
Practice address
8901 W Capitol Dr
Milwaukee, WI 53222-1706
Phone
(414) 463-1880
Fax
(414) 463-2770
NPI assigned
May 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Ms. Amy M Kirby, MSW LCSW
Title
Program Coordinator
Phone
(414) 463-1880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 6949-123 WI Primary

Addresses

Primary practice location

8901 W Capitol Dr
Milwaukee, WI 53222-1706

Mailing address

8901 W Capitol Dr
Milwaukee, WI 53222-1706
Phone (414) 463-1880

Other identifiers 1

IdentifierTypeStateIssuer
6949-123OtherWISTATE OF WISCONSIN CLINICAL SOCIAL WORK LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Saint a5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1609043165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221706",
            "telephone_number": "414-463-1880",
            "fax_number": "414-463-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221706",
            "telephone_number": "414-463-1880",
            "fax_number": "414-463-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST AEMILIAN LAKESIDE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "414-463-1880",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "WI",
            "license": "6949-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN CLINICAL SOCIAL WORK LICENSE",
            "identifier": "6949-123",
            "state": "WI"
        }
    ],
    "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 14, 2008; 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.