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Organization

LOVE OF GRACE ADULT SERVICES

Active
Parent organization
LOVE OF GRACE PNCC SERVICES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LOVE OF GRACE PNCC SERVICES LLC
Authorized official
MS. TAMIA M FREEMAN (OWNER)
(800) 796-0419
Entity
Organization

Contact information

Practice address
4556 N 41ST ST, MILWAUKEE, WI 53209-5818
(262) 281-1574
Mailing address
4556 N 41ST ST, MILWAUKEE, WI 53209-5818
(262) 281-1574

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
311Z00000X
Custodial Care Facility
311ZA0620X
Adult Care Home Facility
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
04/09/2021
Last updated
04/09/2026
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