Clairidge House

LBN: Midway Manor Corp.
Clairidge House is an health care organization with primary practice located at 1519 60Th St , Kenosha WI 53140-3954. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Midway Manor Corp. can be contacted via phone (262) 656-7500, or through Egan, David via phone (262) 656-7500.

Contact Information

Primary practice address
1519 60Th St Kenosha WI 53140-3954
Phone: (262) 656-7500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Egan, David
Phone: (262) 656-7500

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 2823 Wisconsin

Profile Details

NPI number 1801006978
LBN Legal business name Midway Manor Corp.
DBA Doing business as Clairidge House
Authorized official Egan, David
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801006978 NPPES
Wisconsin MEDICAID 20117200

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