Healthcare Provider Details
I. General information
NPI: 1235179292
Provider Name (Legal Business Name): WHEATON FRANCISCAN HEALTHCARE-MARIAN FRANCISCAN CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9632 W APPLETON AVE
MILWAUKEE WI
53225-3305
US
IV. Provider business mailing address
9632 W APPLETON AVE
MILWAUKEE WI
53225-3305
US
V. Phone/Fax
- Phone: 414-461-8850
- Fax:
- Phone: 414-461-8850
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JAMES
GRESHAM
Title or Position: PRESIDENT
Credential:
Phone: 414-535-6907