Organization
METHODIST MANOR, INC.
Active
Other names
Palmer Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ENLUND (PRESIDENT & CEO)
(414) 607-4100
Entity
Organization
Contact information
Practice address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
(414) 607-4502
Mailing address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
(414) 607-4502
Taxonomy
Speciality
Code
Description
License number
State
281P00000X
Chronic Disease Hospital
2300
WI
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2300
WI
314000000X
Skilled Nursing Facility
2300
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20008100
—
WI
01
—
2300
FACILITY LICENSE NUMBER
WI
Enumeration date
03/09/2006
Last updated
04/08/2009
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