GAYLE MILLIS (NPI# 1932574670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932574670 |
Entity Type | Individual |
Full Name | GAYLE MILLIS |
Credential | LPN |
Practice Address |
3260 E Carollton Dr Oak Creek WI 53154-4165 |
Practice Telephone | 2629892366 |
Practice Fax Number | 4143045866 |
Mailing Telephone | 2629892366 |
Mailing Fax Number | 4143045866 |
Enumeration Date | 2015-12-07 |
Last Update Date | 2015-12-07 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 0014938 | WI | Residential Treatment Facilities |
N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 0015707 | WI | Residential Treatment Facilities |
N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 0013030 | WI | Residential Treatment Facilities |
N | 320700000X | Residential Treatment Facility, Physical Disabilities | 0015444 | WI | Residential Treatment Facilities |
N | 320700000X | Residential Treatment Facility, Physical Disabilities | 0013357 | WI | Residential Treatment Facilities |
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 0014242 | WI | Residential Treatment Facilities |
Street Address |
3260 E CAROLLTON DR |
City | OAK CREEK |
State | WI |
Zip Code | 53154-4165 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
1619512605 | Sharon Boushon | Technician | 642 E Pergola Place, Oak Creek, WI 53154 | 2019-11-13 |
1255991386 | Jodi Kruszka | Nurse Practitioner | 825 E Manitowoc Avenue, Oak Creek, WI 53154 | 2019-06-20 |
1184288896 | Thomas Carl Jonson | Durable Medical Equipment & Medical Supplies | 9036 S Carollton Dr., Oak Creek, WI 53154 | 2019-04-29 |
1982127577 | Zainab Saddiq | Optometrist | 8661 S. Howell Ave, 200, Oak Creek, WI 53154 | 2017-07-25 |
1649700980 | Froedtert & The Medical College of Wisconsin Community Physicians, Inc | Durable Medical Equipment & Medical Supplies | 7901 South 6th Street, Oak Creek, WI 53154 | 2017-06-19 |
1770969578 | Suhani Virparia | Pharmacist | 171 W. Town Square Way, Oak Creek, WI 53154 | 2015-08-04 |
1275919144 | Jessica Ford | Social Worker | 8825 South Howell Avenue, Suite 305, Oak Creek, WISCONSIN 53154 | 2015-08-03 |
1700269388 | Tarnit Singh Kapoor | Dentist | 8421 Howell Ave, Oak Creek, WI 53154 | 2015-07-01 |
1447656350 | Kiersten Kirking | Physical Therapist | 210 W. Raindbow Ridge Dr., 1207, Oak Creek, WI 53154 | 2014-11-05 |
Find all providers in zip 53154 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811597933 | Mount Pleasant Homes LLP | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1917 Mount Pleasant St, Racine, WI 53404-2236 | 2020-10-28 |
1730736927 | Horizon Life Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 217 Wisconsin Ave Ste 201, Waukesha, WI 53186-4946 | 2019-08-22 |
1316457203 | James Cares LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2422 Marshall Sq, Kansasville, WI 53139-9763 | 2017-10-05 |
1497271449 | Rescare Residentail Services Wisconsin, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 511 S Pelham St, Rhinelander, WI 54501-3316 | 2017-08-21 |
1144756685 | Safe Haven Senior Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 E 19th St, Marshfield, WI 54449-5074 | 2017-05-03 |
1407209109 | Shepherds Baptist Ministries Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1805 15th Ave, Union Grove, WI 53182-1527 | 2016-07-18 |
1790140382 | Iris Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2339 N 60th St, Wauwatosa, WI 53210-2220 | 2015-12-23 |
1316312218 | A Place for Miracles Living Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7022 N 43rd St, Milwaukee, WI 53209-2219 | 2015-12-03 |
1396088639 | Bell Therapy, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 628 S 68th St, Milwaukee, WI 53214-1608 | 2013-04-05 |
1790039519 | Harbor Hope Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1626 S Park Ave, 908 Baldwin St, Neenah, WI 54956-5025 | 2012-10-31 |
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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.