St. Ann Center for Intergenerational Care

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

5705-16 Issued in WI

Legal business name

ST. ANN CENTER FOR INTERGENERATIONAL CARE

Practice address

2450 W North Ave
Milwaukee, WI 53205

Phone

(414) 977-5000

NPI assigned

Aug 31, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Laura K Chereklaabs, RDH

Title

Director Dental Programs

Phone

(414) 977-5000

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

St Ann Ctr Fam SPPT Cli3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• St Ann Center for Intergenerational Care Inc

  • Health Service Clinic/Center
  • Milwaukee, WI
  • NPI 1144796988
  NPD tax ID
• St Ann Center for Intergenerational Care Inc

  • Adult Day Care Clinic/Center
  • Milwaukee, WI
  • NPI 1629079132
  NPD tax ID

Locations

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1841667466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E MORGAN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532073771",
            "telephone_number": "414-977-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53205",
            "telephone_number": "414-977-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANN CENTER FOR INTERGENERATIONAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "CHEREKLAABS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR DENTAL PROGRAMS",
        "authorized_official_telephone_number": "414-977-5000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WI",
            "license": "5705-16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982075719",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831499532",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023140118",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• St. Charles
• St. Charles Youth & Family Services
• St. Charles Youth & Family Services, Inc.
• St. Charles Youth & Family Services, Inc.
• St. Charles Youth and Family Services

• Public Health or Welfare Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Public Health or Welfare Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.