Healthcare Provider Details

I. General information

NPI: 1609823400
Provider Name (Legal Business Name): WHEATON FRANCISCAN HEALTHCARE - MARIAN FRANCISCAN CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date: 12/29/2008
Reactivation Date: 01/07/2009

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

Practice location:
  • Phone: 414-461-8850
  • Fax:
Mailing address:
  • Phone: 414-461-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES GRESHAM
Title or Position: PRESIDENT - CONTINUING CARE AND ALL
Credential:
Phone: 414-535-6907