| NPI | 1730068719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENTELLA D WEARY Manager/Owner 414-469-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251T00000X PACE Provider Organization |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-09-02 |
| Last Update Date | 2025-09-02 |