| NPI | 1093400087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATANYA PIERCE Owner 414-388-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-04-06 |