| NPI | 1912386574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE GAILLARD Member 414-915-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: WI 0015038) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |