| NPI | 1902695596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENTELLA DENISE WEARY Manager/Owner 414-469-9108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |