# FRIENDS OF FAMILY ADULT HOME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174103162
- **Authorized official:** PWANA MARIE RANDALL (MANAGER/OWNER)
- **Authorized official phone:** (414) 639-2281

## Contact information

- **Practice address:** 5486 N 75TH ST, MILWAUKEE, WI 53218-2712
- **Practice address phone:** (414) 639-2281
- **Practice address fax:** (414) 800-6855
- **Mailing address:** 5322 N 73RD ST, MILWAUKEE, WI 53218-2823
- **Mailing address phone:** (414) 639-2281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/13/2021
- **Last updated:** 04/15/2021