# COREYS PLACE LLC

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

## Provider details

- **NPI number:** 1487275426
- **Authorized official:** MS. CHARLOTTE ADAMS ADMINISTRATOR (ADMINISTRATOR)
- **Authorized official phone:** (414) 324-7265

## Contact information

- **Practice address:** 4049 N 69TH ST, MILWAUKEE, WI 53216-1120
- **Practice address phone:** (414) 324-7265
- **Mailing address:** PO BOX 100892, MILWAUKEE, WI 53210-0892
- **Mailing address phone:** (414) 324-7265

## Taxonomy

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

## Other

- **Enumeration date:** 04/30/2020
- **Last updated:** 04/30/2020