Provider Demographics
NPI:1497119564
Name:ANS CREATIVE BEHAVIORAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ANS CREATIVE BEHAVIORAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-481-9800
Mailing Address - Street 1:1551 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4020
Mailing Address - Country:US
Mailing Address - Phone:414-481-9800
Mailing Address - Fax:414-481-9808
Practice Address - Street 1:1551 S 108TH ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4020
Practice Address - Country:US
Practice Address - Phone:414-481-9800
Practice Address - Fax:414-481-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances