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Organization
HEART OF LYNN ADULT FAMILY HOME
Active
Organization
HEART OF LYNN ADULT FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY POLK (OWNER)
(414) 394-1049
Entity
Organization
Contact information
Practice address
9617 W GOODRICH AVE, MILWAUKEE, WI 53224-2735
(414) 394-1049
Mailing address
4113 N 73RD ST, MILWAUKEE, WI 53216-1043
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
09/30/2026
Last updated
09/30/2026
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