Organization
METHODIST MANOR INC
Active
Other names
Palmer House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ENLUND (PRESIDENT & CEO)
(414) 607-4101
Entity
Organization
Contact information
Practice address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
Mailing address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
NA-CBRF
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013000
—
WI
Enumeration date
03/01/2006
Last updated
04/08/2009
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