Organization Active NPI

Pleasantville Assisted Living

  • Assisted Living Facility
  • Milwaukee, WI
National Provider Identifier
1649063629
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PLEASANTVILLE ASSISTED LIVING
Practice address
4125 N 70TH St
Milwaukee, WI 53216-1163
Phone
(414) 616-1290
Fax
(414) 616-1749
NPI assigned
May 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Keith Martin
Title
President
Phone
(414) 759-6059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4125 N 70TH St
Milwaukee, WI 53216-1163

Mailing address

4125 N 70TH St
Milwaukee, WI 53216-1163
Phone (414) 616-1290

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1649063629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 N 70TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161163",
            "telephone_number": "414-616-1290",
            "fax_number": "414-616-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 N 70TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161163",
            "telephone_number": "414-616-1290",
            "fax_number": "414-616-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANTVILLE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-759-6059"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 23, 2025; 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.