Healthcare Provider Details

I. General information

NPI: 1043191752
Provider Name (Legal Business Name): WEST ALLIS NURSING & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9047 W GREENFIELD AVE
WEST ALLIS WI
53214-2808
US

IV. Provider business mailing address

9047 W GREENFIELD AVE
WEST ALLIS WI
53214-2808
US

V. Phone/Fax

Practice location:
  • Phone: 414-453-9290
  • Fax: 414-777-7356
Mailing address:
  • Phone: 414-453-9290
  • Fax: 414-777-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ROTHNER
Title or Position: MANAGER
Credential:
Phone: 847-261-2400