Healthcare Provider Details

I. General information

NPI: 1477620516
Provider Name (Legal Business Name): JEWISH HOME AND CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 N PROSPECT AVE
MILWAUKEE WI
53202-3018
US

IV. Provider business mailing address

1414 N PROSPECT AVE
MILWAUKEE WI
53202-3018
US

V. Phone/Fax

Practice location:
  • Phone: 414-276-2627
  • Fax: 414-431-1940
Mailing address:
  • Phone: 414-276-2627
  • Fax: 262-478-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2159
License Number StateWI

VIII. Authorized Official

Name: MR. MICHAEL SILVERMAN
Title or Position: PRESIDENT
Credential:
Phone: 414-277-8800