| NPI | 1750176004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARIT PATEL Member 262-939-3666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |