Provider Demographics
NPI:1336790682
Name:MANNAS HOUSE ADULT DAYCARE II, INC
Entity type:Organization
Organization Name:MANNAS HOUSE ADULT DAYCARE II, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-583-0653
Mailing Address - Street 1:1034 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-2502
Mailing Address - Country:US
Mailing Address - Phone:262-902-2420
Mailing Address - Fax:262-583-0653
Practice Address - Street 1:1034 WEST BLVD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-2502
Practice Address - Country:US
Practice Address - Phone:262-902-2420
Practice Address - Fax:262-583-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care