MED GROUP ADULT DAY CARE OF WI, LLC (NPI# 1437409737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437409737 |
Entity Type | Organization |
Organization Name | MED GROUP ADULT DAY CARE OF WI, LLC |
Practice Address |
10549 W Forest Home Ave Hales Corners WI 53130-2057 |
Practice Telephone | 4147550558 |
Practice Fax Number | 4147552470 |
Mailing Telephone | 4147550558 |
Mailing Fax Number | 4147552470 |
Enumeration Date | 2012-09-13 |
Last Update Date | 2012-09-13 |
Authorized Official Name | DARIKO MEKVABISHVILI (PRESIDENT) |
Authorized Official Telephone | 4147550558 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
Street Address |
10549 W FOREST HOME AVE |
City | HALES CORNERS |
State | WI |
Zip Code | 53130-2057 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962995563 | Leo A Levesque IIi | Chiropractor | Chiro One Wellness Center of Hales Corners LLC, 5305 S 108th St, Hales Corners, WI 53130 | 2018-06-08 |
1730512286 | Rebecca Lynn Gnas | Chiropractor | 10731 W. Forest Home Avenue, Hales Corners, WI 53130 | 2013-08-19 |
1316097843 | Michael S. Kotkin | Psychologist | 9415 W. Forest Home Ave. Suite 104, Hales Corners, WI 53130 | 2007-01-10 |
1588713705 | Dennis Keith Wolf | Social Worker | 12065 W Janesville Road, Hales Corners, WI 53130 | 2007-01-09 |
1124186978 | Briar House Facility Lpc Briar I | Assisted Living Facility | 10133 W Brookside Dr, Hales Corner, WI 53130 | 2006-12-05 |
1598837171 | Gilbert Jerome Brickler | Dentist | 6080 South 108th St, Suite 111 Gilbert J Brickler Dds, Hales Corners, WI 53130 | 2006-11-15 |
1306957840 | Donald Allen Whitlock | Dentist | 11035 W. Forest Home Ave, #116, Hales Corners, WI 53130 | 2006-08-31 |
1528074309 | James C. Boudreau, Dpm, Sc | Podiatrist | 6191 S. 108th St., Hales Corners, WI 53130 | 2006-07-31 |
1912441437 | Katheryn Elizabeth Hurst | Physical Therapist | 5764 S 108th St, Hales Corners, WI 53130 | 2016-12-19 |
1417115700 | Richard Anthony Mueller | Dentist | 11801 W Janesville Rd, Hales Corners, WI 53130 | 2008-05-23 |
Find all providers in zip 53130 |
Taxonomy Code | 311Z00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Custodial Care Facility |
A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023643699 | County of La Crosse | Custodial Care Facility | 994 Garland St E, West Salem, WI 54669 | 2020-03-04 |
1235763053 | County of La Crosse | Custodial Care Facility | 848 Garland St E, West Salem, WI 54669 | 2020-03-02 |
1265066096 | County of La Crosse | Custodial Care Facility | 998 Garland St E, West Salem, WI 54669 | 2020-03-02 |
1164729877 | Licensed To Care | Custodial Care Facility | 5846 N 68th St, Milwaukee, WI 53218-1808 | 2011-02-15 |
1912156530 | Grace Adult Day Services - Altoona | Custodial Care Facility | 2441 New Pine Dr, Altoona, WI 54720-3300 | 2008-09-18 |
1396994992 | Grace Adult Day Services - Chippewa Falls | Custodial Care Facility | 2050 County Highway I, Chippewa Falls, WI 54729-4416 | 2008-09-18 |
1194909341 | Benevolent Corporation Cedar Community | Custodial Care Facility | 113 Cedar Ridge Dr, West Bend, WI 53095-3654 | 2007-12-24 |
1295803971 | Health Managment Consortium | Custodial Care Facility | 1133 4th Ave S, Park Falls, WI 54552-1922 | 2006-12-01 |
City | HALES CORNERS |
Zip Code | 53130 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.