| NPI | 1114287984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER R SWIM Liscensee 1715-897-1207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WI 14175) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |