# CREAM CITY COMFORTABLE LIVING 2

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

## Provider details

- **NPI number:** 1952187007
- **Authorized official:** KIRBY LOCKETT (OWNER)
- **Authorized official phone:** (414) 610-0124

## Contact information

- **Practice address:** 6336 N 104TH ST, MILWAUKEE, WI 53225-1408
- **Practice address phone:** (414) 610-0124
- **Mailing address:** 5132 W MILL RD, MILWAUKEE, WI 53218-1302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/05/2023
- **Last updated:** 09/05/2023