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General NPI Number Information
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NPI Number | 1437156676
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Entity Type | Organization
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Legal Business Name | FRANCISCAN VILLA OF SOUTH MILWAUKEE, INC.
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 3601 S CHICAGO AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-3708
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Country | US
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Telephone | 414-764-4100
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Fax | 414-764-0706
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Provider Business Mailing Address
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Address Line | 3601 S CHICAGO AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-3708
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Country | US
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Telephone | 414-764-4100
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Fax | 414-764-0706
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CHARLEAN ADAMS
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Credential |
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Telephone | 414-764-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2185
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License Number State | WI
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