LAKE VIEW ADULT FAMILY HOME

PEWAUKEE, WI
NPI1710119151
Entity TypeOrganization
Authorized ContactDOUANGMALA PHRASAVATH
Registered Nurse
414-379-9713
Organization Subpart ?No
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2009-08-19
Last Update Date2009-08-19
Business Address
LAKE VIEW ADULT FAMILY HOME
W278N2456 PROSPECT AVE
PEWAUKEE, WI 53072-5220
Phone number: 414-379-9713
Mailing Address
LAKE VIEW ADULT FAMILY HOME
W278N2456 PROSPECT AVE
PEWAUKEE, WI 53072-5220
Phone number: 414-379-9713