Organization
NEW CREATIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NOTKIA SHENEE DELAROSA CNA (OWNER)
(414) 254-8216
Entity
Organization
Contact information
Practice address
5151 N 58TH ST, MILWAUKEE, WI 53218-4251
(414) 395-3819
(414) 395-3819
Mailing address
5151 N 58TH ST, MILWAUKEE, WI 53218-4251
(414) 395-3819
(414) 395-3819
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
243369
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
243369
CNA
WI
Enumeration date
03/14/2013
Last updated
03/14/2013
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