Organization
CECELIA SENIOR HOMES OF WEST ALLIS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD J KALLAS M.D. (MEDICAL DIRECTOR)
(262) 695-6408
Entity
Organization
Contact information
Practice address
1437 N SUMMIT AVE, OCONOMOWOC, WI 53066-9461
(414) 322-1434
Mailing address
1437 N SUMMIT AVE, OCONOMOWOC, WI 53066-9461
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
14655-20
WI
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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