| NPI | 1336679018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABOONIE TATUM Manager 414-915-8189 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 177F00000X Lodging |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-06-16 |