Healthcare Provider Details

I. General information

NPI: 1952905069
Provider Name (Legal Business Name): ASCENSION ALL SAINTS HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 W VILLARD AVE
MILWAUKEE WI
53209-4901
US

IV. Provider business mailing address

PO BOX 860004
MINNEAPOLIS MN
55486-6000
US

V. Phone/Fax

Practice location:
  • Phone: 414-527-8191
  • Fax:
Mailing address:
  • Phone: 414-527-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MCCULLOUGH
Title or Position: CFO
Credential:
Phone: 414-465-3736