Healthcare Provider Details

I. General information

NPI: 1811782477
Provider Name (Legal Business Name): WATSON FUNERAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 W WILLOW RD
BROWN DEER WI
53223-3659
US

IV. Provider business mailing address

5141 W WILLOW RD
BROWN DEER WI
53223-3659
US

V. Phone/Fax

Practice location:
  • Phone: 708-837-4308
  • Fax:
Mailing address:
  • Phone: 708-837-4308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LORI ARDELL WATSON
Title or Position: 'OWNER
Credential:
Phone: 708-837-4308