Plymouth Manor Nursing & Rehabilitation Center

LBN: Extendicare Homes, Inc.
Plymouth Manor Nursing & Rehabilitation Center is an health care organization with primary practice located at 619 W Walnut St , Milwaukee WI 53212-3839. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Extendicare Homes, Inc. can be contacted via phone (414) 263-1770, or through Maassen, Donna Jo via phone (414) 908-8119.

Contact Information

Primary practice address
619 W Walnut St Milwaukee WI 53212-3839
Phone: (414) 263-1770
Fax: (414) 263-2467
Website:
Map and Directions
Authorized official contact:
Name: Maassen, Donna Jo
Phone: (414) 908-8119

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1215001862
LBN Legal business name Extendicare Homes, Inc.
DBA Doing business as Plymouth Manor Nursing & Rehabilitation Center
Authorized official Maassen, Donna Jo
Entity Organization
Organization subpart 1 No
Enumeration date Nov 17th, 2006
Last updated Apr 7th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215001862 NPPES
Wisconsin MEDICAID 20115800

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