Organization
METHODIST MANOR OF WAUKESHA, INC.
Active
Other names
Ruth Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ENLUND (PRESIDENT & CEO)
(414) 607-4100
Entity
Organization
Contact information
Practice address
8300 W BELOIT RD, WEST ALLIS, WI 53219-2412
(414) 607-4451
(414) 607-4459
Mailing address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
(414) 607-4502
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
2002
WI
315D00000X
Inpatient Hospice
Primary
2002
WI
385H00000X
Respite Care
2002
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002
FACILITY LICENSE NUMBER
WI
05
—
43190000
—
WI
Enumeration date
03/10/2006
Last updated
04/08/2009
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