| NPI | 1306770342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINQUE RAYVON BELL Caregiver 414-397-1388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2026-06-12 |
| Last Update Date | 2026-07-21 |