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Organization
LOVING ELDERLY ADULT DAY CARE CENTER LLC
Active
Organization
LOVING ELDERLY ADULT DAY CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NCAIS THAO VANG (OWNER)
(414) 243-5745
Entity
Organization
Contact information
Practice address
7017 N 58TH ST, MILWAUKEE, WI 53223-5204
(414) 207-6796
Mailing address
7017 N 58TH ST, MILWAUKEE, WI 53223-5204
(414) 207-6796
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017963
CETIFICATE
WI
01
—
V5206389587103
ID
WI
Enumeration date
03/12/2020
Last updated
03/12/2020
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