OrganizationExtendeed Care CenterSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5000 W National Ave, Bldg 70-E-106, Milwaukee, WI 53295-0001(414) 384-2000PECOS EnrollmentBased on the most recent information from CMS, provider Extendeed Care Center does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1487051272Provider TypeOrganizationFull NameExtendeed Care CenterSubpartNoEnumeration Date11/24/2014Last Updated11/24/2014Contact InformationPractice LocationPractice Address5000 W National Ave, Bldg 70-E-106, Milwaukee, WI 53295-0001Phone(414) 384-2000FaxUnlisted FaxMailing LocationMailing Address3055 S Fountain Square Blvd, Apt 207, New Berlin, WI 53151-3999Phone(414) 384-2000FaxUnlisted FaxAuthorized OfficialNameBykowski, Samantha J (Social Worker)Phone(414) 384-2000Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense129106Wisconsin