Organization
BIG MAMA HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOHNELLE SHARNISE SMITH (OWNER)
(414) 722-7304
Entity
Organization
Contact information
Practice address
3365 N 53RD ST, MILWAUKEE, WI 53216-3260
(414) 722-7304
Mailing address
3365 N 53RD ST, MILWAUKEE, WI 53216-3260
(414) 722-7304
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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