Mitchell Manor

LBN: Five Star Quality Care-Wi, Llc
Mitchell Manor is an health care organization with primary practice located at 5301 West Lincoln Avenue , West Allis WI 53219-1652. 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. Five Star Quality Care-Wi, Llc can be contacted via phone (414) 615-7200, or through Potter, Katherine E via phone (617) 796-8387.

Contact Information

Primary practice address
5301 West Lincoln Avenue West Allis WI 53219-1652
Fax: (414) 615-7260
Website:
Authorized official contact:
Name: Potter, Katherine E

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 3181 Wisconsin

Profile Details

NPI number 1417944612
LBN Legal business name Five Star Quality Care-Wi, Llc
DBA Doing business as Mitchell Manor
Authorized official Potter, Katherine E
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 3rd, 2005
Last updated Mar 27th, 2019 - about 3 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 1417944612 NPPES
Wisconsin MEDICAID 20201200

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