Organization
LEGACY SOBRIETY AND RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIDA CLIFTON (OWNER)
(414) 309-3213
Entity
Organization
Contact information
Practice address
2810 W KILBOURN AVE APT 3, MILWAUKEE, WI 53208-3501
(414) 309-3213
(414) 309-3213
Mailing address
2810 W KILBOURN AVE APT 3, MILWAUKEE, WI 53208-3501
(414) 309-3213
(414) 309-3213
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/21/2025
Last updated
10/24/2025
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