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Organization
DIVINE GRACE ADULT FAMILY HOME LLC
Active
Organization
DIVINE GRACE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE JACKSON SR (OWNER)
(414) 379-3001
Entity
Organization
Contact information
Practice address
7727 W GLENDALE AVE, MILWAUKEE, WI 53218-5331
(414) 274-9935
Mailing address
7727 W GLENDALE AVE, MILWAUKEE, WI 53218-5331
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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