Organization
HAVEN OF PEACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALIKA A NICKELSON (CHIEF OF OPERATIONS)
(414) 739-7587
Entity
Organization
Contact information
Practice address
3032 N 6TH ST, MILWAUKEE, WI 53212-1907
(414) 739-7587
Mailing address
PO BOX 11143, MILWAUKEE, WI 53211-0143
(414) 739-7587
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/16/2021
Last updated
03/23/2022
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