METHODIST MANOR, INC.

Nursing Facility/Intermediate Care Facility

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

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Contact Information

METHODIST MANOR, INC.

3023 S 84TH ST
WEST ALLIS, WI 53227-3703

Phone: 414-607-4100
Fax: 414-607-4502
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Nursing Facility/Intermediate Care Facility	313M00000X	A3[10]	Other Nursing Facility
Chronic Disease Hospital	281P00000X
Skilled Nursing Facility	314000000X	A1[8]	Skilled Nursing Facility

Indicates primary specialty

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NPI Profile & details for METHODIST MANOR, INC.

NPI Number 1972571628

LBN Legal business name METHODIST MANOR, INC.

Authorized official JAMES ENLUND - (PRESIDENT & CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/09/2006

Last updated 04/08/2009 - About 17 years ago

Identifiers

WI	License #	2300
WI	Medicaid	20008100
WI	Other	2300	FACILITY LICENSE NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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