| NPI | 1003606690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIDA T CLIFTON Owner 414-309-3213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 310400000X Assisted Living Facility | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-10-24 |