| NPI | 1043554090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILAH RASHADA Owner 414-840-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: WI 0013901) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: WI 0013901) |
| 385H00000X Respite Care (Licence: WI 0013901) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |