| NPI | 1093641128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMONT LEDELL JOHNSON Owner/CEO 414-791-9929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2026-06-18 |
| Last Update Date | 2026-06-18 |