| NPI | 1568223931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALONG M EVANS Owner 414-739-7587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |