# METHODIST MANOR HEALTH CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maplewood Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134196983
- **Authorized official:** MR. JAMES ENL/UND (PRESIDENT & CEO)
- **Authorized official phone:** (414) 607-4101

## Contact information

- **Practice address:** 8615 W BELOIT RD, WEST ALLIS, WI 53227-3711
- **Practice address phone:** (414) 607-4100
- **Practice address fax:** (414) 607-4502
- **Mailing address:** 3023 S 84TH ST, WEST ALLIS, WI 53227-3703
- **Mailing address phone:** (414) 607-4100
- **Mailing address fax:** (414) 607-4502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | 2153 | WI | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 2153 | WI | — |
| 314000000X | Skilled Nursing Facility | 2153 | WI | Yes |

## Other

- **Enumeration date:** 03/01/2006
- **Last updated:** 04/08/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2013000 | — | WI |