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General NPI Number Information
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NPI Number | 1932522125
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Entity Type | Individual
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Provider Name | MRS. GLORIA PIPHUS
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Gender | Female
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 5570 W ROOSEVELT DR
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City | MILWAUKEE
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State | WI
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Zip | 53216-3152
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Country | US
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Telephone | 414-444-5512
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Fax | 414-444-2779
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Provider Business Mailing Address
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Address Line | 5570 W ROOSEVELT DR
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City | MILWAUKEE
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State | WI
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Zip | 53216-3152
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Country | US
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Telephone | 414-444-5512
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Fax | 414-444-2779
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | 0018383
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 0018383
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 414840000
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License Number State | WI
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