| NPI | 1790275378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA D MCCLOUD Owner 414-366-8898 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 253Z00000X In Home Supportive Care | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-06-16 |