# RUSTIC MANOR HOMES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rustic Manor Homes, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205628062
- **Authorized official:** CYNTHIA SIMPSON (DIRECTOR)
- **Authorized official phone:** (262) 353-1910

## Contact information

- **Practice address:** 2904 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3134
- **Practice address phone:** (262) 353-1910
- **Practice address fax:** (262) 353-1910
- **Mailing address:** 3383 E LAYTON AVE, CUDAHY, WI 53110-1437
- **Mailing address phone:** (414) 485-7088
- **Mailing address fax:** (414) 485-7088

## Taxonomy

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

## Other

- **Enumeration date:** 05/19/2025
- **Last updated:** 05/19/2025