| Organization Name: | METHODIST MANOR OF WAUKESHA, INC. |
| NPI Number: | 1750359220 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES ENLUND (PRESIDENT & CEO) |
| Mailing Address: | 8300 W Beloit Rd West Allis |
| State: | WI US |
| Postal Code: | 532192412 |
| Phone Number: | 4146074451 |
| Fax Number: | 4146074459 |
| NPI Enumeration Date: | 03/10/2006 |
| NPI Last Update Date: | 04/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 2002 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |