| NPI | 1386397388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIE SEGURA Admin 414-312-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 174200000X Meals |
| 251B00000X Case Management | |
| 251J00000X Nursing Care | |
| 310400000X Assisted Living Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-02-28 |