Iris Manor

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

IRIS MANOR

Practice address

2339 N 60TH St
Wauwatosa, WI 53210-2220

Phone

(414) 778-1222

Fax

(414) 778-1002

NPI assigned

Dec 23, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia Soto

Title

Billing

Phone

(414) 315-0429

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1790140382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 N 60TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532102220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 N 60TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532102220",
            "telephone_number": "414-778-1222",
            "fax_number": "414-778-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIS MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "414-315-0429",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.