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General NPI Number Information
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NPI Number | 1902804586
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Entity Type | Organization
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Legal Business Name | MILWAUKEE CATHOLIC HOME, INC.
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 2330 N PROSPECT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-4455
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Country | US
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Telephone | 414-220-4610
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Fax | 414-220-8495
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Provider Business Mailing Address
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Address Line | 2330 N PROSPECT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-4455
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Country | US
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Telephone | 414-220-4610
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Fax | 414-220-8495
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. ROHINI J. DESAI
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Credential |
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Telephone | 414-220-8468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 3213
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License Number State | WI
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