Provider Demographics
NPI:1063186328
Name:WAUKESHA OPS, LLC
Entity type:Organization
Organization Name:WAUKESHA OPS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP FINANCE & ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSOPUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-241-8211
Mailing Address - Street 1:5900 CLEARWATER DR STE 500
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8961
Mailing Address - Country:US
Mailing Address - Phone:952-241-8211
Mailing Address - Fax:952-241-8232
Practice Address - Street 1:1701 E BROADWAY
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-8127
Practice Address - Country:US
Practice Address - Phone:262-955-1998
Practice Address - Fax:952-241-8232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAUKESHA PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility