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NPI Code Detail

MEDICARE: WHEATON FRANCISCAN HEALTHCARE-MARIAN FRANCISCAN CENTER,INC

MEDICARE: WHEATON FRANCISCAN HEALTHCARE-MARIAN FRANCISCAN CENTER,INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility2956WI

General Provider Information

NPI Number : 1235151937
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEATON FRANCISCAN HEALTHCARE-MARIAN FRANCISCAN CENTER,INC
Provider Business Mailing Address
First Line : 19525 W NORTH AVE
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-4107
Country : US
Telephone Number : 262-785-1114
Fax Number : 262-780-3805
Provider Business Practice Location Address
First Line : 19525 W NORTH AVE
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-4107
Country : US
Telephone Number : 262-785-1114
Fax Number : 262-780-3805
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARY H PIETTE
Credential :
Telephone Number : 262-780-3100
Provider Enumeration Date : 07/24/2006
Last Update Date : 11/13/2009

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