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Organization

FERVENT CARE ADULT HOME INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEZAR BURNSIDE (MANAGER)
(414) 935-2513
Entity
Organization

Contact information

Practice address
4957 N 18TH ST, MILWAUKEE, WI 53209-5755
(414) 935-2513
(414) 935-2513
Mailing address
4957 N 18TH ST, MILWAUKEE, WI 53209-5755
(414) 935-2513
(414) 935-2513

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0015402
WI

Other

Enumeration date
01/11/2018
Last updated
01/11/2018
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