1992763080 NPI number — FORT AUSTIN LIMITED PARTNERSHIP

Table of content: (NPI 1992763080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992763080 NPI number — FORT AUSTIN LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FORT AUSTIN LIMITED PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BROOKDALE WESTLAKE HILLS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992763080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6737 W WASHINGTON ST STE 2300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53214-5650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-918-5000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1034 LIBERTY PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78746-6891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-328-3775
Provider Business Practice Location Address Fax Number:
512-329-6533
Provider Enumeration Date:
05/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LESKOWICZ
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
414-918-5000

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 116948 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000213 . This is a "TX HEALTH & HUMAN SERVICES COMMISSION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".