| NPI | 1588591085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADASHIA CANNON Owner 414-460-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 385H00000X Respite Care | |
| Enumeration Date | 2026-05-07 |
| Last Update Date | 2026-05-07 |