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1598581647
CLEAN SLATE ADULT FAMILY HOME CORP.
MILWAUKEE, WI
NPI
1598581647
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Entity Type
Organization
Authorized Contact
TYRONE SIMMON
Owner
630-234-4783
Organization Subpart ?
No
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
Enumeration Date
2024-11-22
Last Update Date
2024-11-22
Business Address
CLEAN SLATE ADULT FAMILY HOME CORP.
5102 N 77TH ST
MILWAUKEE, WI 53218-3701
Phone number: 414-616-1668
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Mailing Address
CLEAN SLATE ADULT FAMILY HOME CORP.
5743 N 77TH ST
MILWAUKEE, WI 53218-2144
Phone number: 630-234-4783
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