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Organization
CREAM CITY COMFORTABLE LIVING 2
Active
Organization
CREAM CITY COMFORTABLE LIVING 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRBY LOCKETT (OWNER)
(414) 610-0124
Entity
Organization
Contact information
Practice address
6336 N 104TH ST, MILWAUKEE, WI 53225-1408
(414) 610-0124
Mailing address
5132 W MILL RD, MILWAUKEE, WI 53218-1302
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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