Provider Demographics
NPI:1356217970
Name:TRUSTWELL LIVING AT OAK CREEK PLACE
Entity type:Organization
Organization Name:TRUSTWELL LIVING AT OAK CREEK PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:POOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-638-3408
Mailing Address - Street 1:3829 S CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-3712
Mailing Address - Country:US
Mailing Address - Phone:414-762-3838
Mailing Address - Fax:
Practice Address - Street 1:3829 S CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-3712
Practice Address - Country:US
Practice Address - Phone:414-762-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility