| NPI | 1093457210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANE NELSON CEO 262-342-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2022-04-08 |