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General NPI Number Information
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NPI Number | 1639339518
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Entity Type | Organization
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Legal Business Name | UNITED LUTHERAN PROGRAM FOR THE AGING, INC.
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 4545 N 92ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53225
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Country | US
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Telephone | 414-464-3880
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Fax | 414-464-5834
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Provider Business Mailing Address
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Address Line | 4545 N 92ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53225-4807
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Country | US
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Telephone | 414-464-3880
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Fax | 414-464-5834
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Authorized Official
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Title or Position | CFO
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Name | ARTHUR ALLEN KEUP
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Credential |
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Telephone | 414-464-6396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 0934
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License Number State | WI
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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 | 0934
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License Number State | WI
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