| NPI | 1346815636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANNE YOPPS Executive Assistant 414-930-4421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |