Organization
HUMBLE LIVING HOME TWO
Active
Parent organization
HUMBLE LIVING ADULT FAMILY GROUP HOME LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HUMBLE LIVING ADULT FAMILY GROUP HOME LLC
Authorized official
VERSHAUNDA CAMPBELL (OWNER)
(262) 239-1138
Entity
Organization
Contact information
Practice address
923 TOWER LN, WEST BEND, WI 53090-2425
(262) 239-1138
Mailing address
923 TOWER LN, WEST BEND, WI 53090-2425
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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