| NPI | 1992676902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONNEY LOCKRIDGE Owner 262-527-7490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-15 |