| NPI | 1326886128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIQADIR A MOHAMED Services Provider 608-556-5281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-09-05 |