| NPI | 1639413958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA S JACKSON Owner / Administrator 414-943-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: WI 0013321) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |