| NPI | 1013732007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONDA JACKSON Owner/Operator 414-391-5247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2024-11-15 |
| Last Update Date | 2024-11-15 |