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NPI Code Detail

MEDICARE: ST ANN CENTER FOR INTERGENERATIONAL CARE INC

MEDICARE: ST ANN CENTER FOR INTERGENERATIONAL CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse7033-031WI
2225X00000XOccupational Therapist685-026WI
3261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629079132
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST ANN CENTER FOR INTERGENERATIONAL CARE INC
Provider Business Mailing Address
First Line : 2801 E MORGAN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-3771
Country : US
Telephone Number : 414-977-5000
Fax Number :
Provider Business Practice Location Address
First Line : 2801 E MORGAN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-3771
Country : US
Telephone Number : 414-977-5000
Fax Number : 414-977-5050
Authorized Official
Title or Position : PRESIDENT
Name : EDNA LONERGAN
Credential :
Telephone Number : 414-977-5000
Provider Enumeration Date : 08/09/2005
Last Update Date : 03/03/2021

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Practice Fax: 414-977-5011
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1033372685 — MS. CATHLEEN DENISE FOSTER MS, OTR
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Practice Fax: 414-977-5011
1538322185 — KAREN SZYDEL COTA
Practice Location Address:
2801 E MORGAN AVE
MILWAUKEE, WI
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Practice Fax:
1467780601 — EDNA LONERGAN OTR
Practice Location Address:
2801 E MORGAN AVE
MILWAUKEE, WI
53207-3771
Practice Phone: 414-977-5000
Practice Fax:
1518215979 — TONI ALVAREZ
Practice Location Address:
2801 E MORGAN AVE
MILWAUKEE, WI
53207-3771
Practice Phone: 414-977-5024
Practice Fax: 414-977-5012

Directions to “ST ANN CENTER FOR INTERGENERATIONAL CARE INC ” Practice Location

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