Organization
MARYANN ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIQUITA LEWIS (OWNER)
(414) 640-1042
Entity
Organization
Contact information
Practice address
3008 W CARMEN AVE, MILWAUKEE, WI 53209-4235
(414) 640-1042
Mailing address
PO BOX 101010, MILWAUKEE, WI 53210-7010
(414) 640-1042
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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