| NPI | 1306336870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANESE MCCLENDON CEO 414-839-4755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2021-09-21 |