| NPI | 1366711269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDA LYNN KULCSAR Owner 414-305-5714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: FL 245874) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |