| NPI | 1942077433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKALIA PARKER Owner 414-202-0378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-05 |