Healthcare Provider Details

I. General information

NPI: 1477226249
Provider Name (Legal Business Name): KASTLE COMMUNITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7675 N 76TH ST
MILWAUKEE WI
53223-4017
US

IV. Provider business mailing address

6051 W BROWN DEER RD STE 105
BROWN DEER WI
53223-2263
US

V. Phone/Fax

Practice location:
  • Phone: 414-751-7772
  • Fax:
Mailing address:
  • Phone: 414-446-5578
  • Fax: 414-446-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WU0100X
TaxonomyUrology Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANICE MATTHEWS
Title or Position: REGISTERED NURSE
Credential: BSN
Phone: 414-446-5578