Chp Shorewood Wi Tenant Corp

NPI #1164965257 in Shorewood, Wisconsin

Provider Information

NPI Number
1164965257
Entity Type
Organization
Organization Name
Chp Shorewood Wi Tenant Corp
Primary Specialty
Assisted Living Facility
Enumeration Date
Nov 22, 2016
Last Updated
Nov 22, 2016

Practice Location

Address
1111 E CAPITOL DR
ZIP Code
53211-1810
Phone
(414) 436-0311

Authorized Official

Name
THOMAS MITCHELL
Title
CFO OF MANAGER
Phone
(772) 492-5002

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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