Methodist Manor of Waukesha, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

METHODIST MANOR OF WAUKESHA, INC.

Doing business as

Greenville Manor

Practice address

W7098 Buttercup CT
Greenville, WI 54942-9048

Phone

(920) 757-0996

Fax

(920) 757-0973

NPI assigned

Mar 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. James Enlund

Title

President & Ceo

Phone

(414) 607-4100

Specialties & licenses 1

Addresses

Other names 1

• Greenville Manor Doing business as

Tax ID family

Greenville Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Methodist Manor of Waukesha, Inc.

  • Inpatient Hospice
  • Milwaukee, WI
  • NPI 1952378648
  NPD tax ID

Locations

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1619944303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 S 84TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273703",
            "telephone_number": "414-607-4100",
            "fax_number": "414-607-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W7098 BUTTERCUP CT",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549429048",
            "telephone_number": "920-757-0996",
            "fax_number": "920-757-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MANOR OF WAUKESHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "ENLUND",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "414-607-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Klieforth
• Julia M La Maide, RN
• Kari L Lathrop Capaul, MD
• Kasi Lee Ludwig, PHARMD
• Melissa B Matson, PT
• Jessica Micoley
• Morton Drug Co Inc
• Jaclyn Mullins, MD
• National Seating & Mobility, Inc.
• NCS Healthcare of Wisconsin, LLC

• Assisted Living Facility in Greenville, WI
• Providers in Greenville, 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 Apr 8, 2009; 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.