| NPI | 1841189495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER R EDWARDS Owner/Operator 414-807-2446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2026-06-22 |