MEDICARE: CASTLE SENIOR LIVING, 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
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2055	OTHER	WI	PROVISIONAL LICENSE

General Provider Information

NPI Number	:	1992317762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASTLE SENIOR LIVING, INC

Provider Business Mailing Address
First Line	:	13040 W CLEVELAND AVE STE 300H
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-4014
Country	:	US
Telephone Number	:	414-930-4432
Fax Number	:	262-977-7746

Provider Business Practice Location Address
First Line	:	13040 W CLEVELAND AVE STE 300H
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-4014
Country	:	US
Telephone Number	:	414-930-4432
Fax Number	:	262-977-7746

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. ELIZABETH MOORE WAITE
Credential	:	MHA
Telephone Number	:	414-403-5007

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	04/14/2026

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