IRIS MANOR NPI 1790140382

NPI Information

NPI: 1790140382
Provider Name: IRIS MANOR
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
2339 N 60TH ST
WAUWATOSA, WI
ZIP 53210
Phone: (414) 778-1222
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IRIS MANOR is a community based residential treatment facility, intellectual and/or developmental disabilities in Wauwatosa, WI. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. IRIS MANOR NPI is 1790140382. The provider is registered as an organization entity type.

The provider's business location address is:

2339 N 60TH ST
WAUWATOSA, WI
ZIP 53210-220
Phone: (414) 778-1222
Fax: (414) 778-1002

The provider's authorized official is Cynthia Soto .
The authorized official title is Billing and has the following contact phone number (414) 315-0429.

The enumeration date for this NPI number is 12/23/2015 and was last updated on 12/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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