Provider Demographics
NPI:1275682742
Name:CLEARVIEW HOME CORPORATION
Entity Type:Organization
Organization Name:CLEARVIEW HOME CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-646-3361
Mailing Address - Street 1:935 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-0198
Mailing Address - Country:US
Mailing Address - Phone:262-646-3361
Mailing Address - Fax:262-646-3361
Practice Address - Street 1:935 MAIN ST.
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-0198
Practice Address - Country:US
Practice Address - Phone:262-646-3361
Practice Address - Fax:262-646-3361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0940282J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI52-1990Medicare ID - Type Unspecified