Organization
GENESIS SUPPORTIVE LIVING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WELLINGTON M WARREN (DIRECTOR)
(414) 562-2567
Entity
Organization
Contact information
Practice address
1545 N 7TH ST, MILWAUKEE, WI 53205-2347
(414) 562-2567
Mailing address
1545 N 7TH ST, MILWAUKEE, WI 53205-2347
(414) 562-2567
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
WI
Other
Enumeration date
02/09/2010
Last updated
04/06/2011
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