| NPI | 1164729877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA NICOLE BLAIR Lpn 414-462-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) (Licence: WI 303906-031) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: WI 303906-031) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |