| NPI | 1942901160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA M WILCOXSON Owner 414-510-6335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-03-14 |