Provider Demographics
NPI:1962099937
Name:ARIA AT MITCHELL MANOR
Entity type:Organization
Organization Name:ARIA AT MITCHELL MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NETANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-983-4860
Mailing Address - Street 1:8150 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2974
Mailing Address - Country:US
Mailing Address - Phone:847-983-4860
Mailing Address - Fax:
Practice Address - Street 1:5301 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53219-1652
Practice Address - Country:US
Practice Address - Phone:414-615-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility