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1841644481
ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC
RACINE, WI
NPI
1841644481
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Entity Type
Organization
Authorized Contact
JERODD TAYLOR
Owner
262-880-5606
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
(Licence: WI 0016022)
Enumeration Date
2016-04-20
Last Update Date
2016-04-20
Business Address
ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC
1715 LASALLE ST
RACINE, WI 53402-4824
Phone number: 262-902-3442
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Mailing Address
ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC
6210 BLUE RIVER WAY
RACINE, WI 53402-9448
Phone number: 262-880-5606
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