SNH Wis Tenant LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SNH WIS TENANT LLC

Doing business as

Mitchell Manor

Practice address

5301 W Lincoln Ave
West Allis, WI 53219-1652

Phone

(414) 615-7200

Fax

(414) 615-7398

NPI assigned

Aug 22, 2019

Organization subpart

Yes

Parent organization

SNH WIS TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mitchell Manor Doing business as

Part of

SNH Wis Tenant LLC

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1912554023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191652",
            "telephone_number": "414-615-7200",
            "fax_number": "414-615-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH WIS TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH WIS TENANT LLC",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynne Smith, NP
• Margaret Smith
• Seth E Smith, MD
• Viviette Iona Smith
• Daniel M Smullen, M.D.
• Michelle Snowden-Felerski, PT
• Rachel Snyder, DPT
• Social Rehabilitation and Residential Resources, Inc.
• Social Rehabilitation and Residential Resources, Inc.
• Laura Mercedes Socias, D.D.S.

• Skilled Nursing Facility in West Allis, WI
• Providers in West Allis, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.