Provider Demographics
NPI:1245722347
Name:CHINGOTA-GRIFFANO, ARITHER HANNAH
Entity type:Individual
Prefix:
First Name:ARITHER
Middle Name:HANNAH
Last Name:CHINGOTA-GRIFFANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7863 N 76TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-3913
Mailing Address - Country:US
Mailing Address - Phone:414-460-5056
Mailing Address - Fax:
Practice Address - Street 1:813 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1503
Practice Address - Country:US
Practice Address - Phone:414-366-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0017108311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home