NPI | 1982999090 |
---|---|
Entity Type | Organization |
Authorized Contact | GOLD OMEREONYE Owner 414-975-0121 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WI 126208-30) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2011-06-16 |