Organization
V&R ADULT FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JACKSON LPN (OWNER)
(414) 628-5102
Entity
Organization
Contact information
Practice address
3211 N 3RD ST, MILWAUKEE, WI 53212-2023
(414) 837-0353
Mailing address
3211 N 3RD ST, MILWAUKEE, WI 53212-2023
(414) 837-0353
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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