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Organization
REGENCY SENIOR SERVICES LLC
Active
Organization
REGENCY SENIOR SERVICES LLC
Active
Other names
Dove Healthcare at Glendale
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA C ROOP (DIRECTOR OF REIMBURSEMENT)
(863) 676-1512
Entity
Organization
Contact information
Practice address
1633 W BENDER RD, MILWAUKEE, WI 53209-3801
(414) 228-9440
(414) 228-6320
Mailing address
1633 W BENDER RD, MILWAUKEE, WI 53209-3801
(414) 228-9440
(414) 228-6320
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3185
WI
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20182800
—
WI
Enumeration date
06/30/2005
Last updated
08/20/2008
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