Organization
LOVE 4 LIFE LLC
Active
Other names
MC Nickelson Haven of Love
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JALONG M EVANS (OWNER)
(414) 739-8323
Entity
Organization
Contact information
Practice address
3032 N 6TH ST, MILWAUKEE, WI 53212-1907
(414) 739-8323
Mailing address
2359 N SHERMAN BLVD, MILWAUKEE, WI 53210-2945
(414) 739-8323
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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