Organization
JEFFERSON CREST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL E TAYLOR (CEO/PRESIDENT)
(414) 688-7272
Entity
Organization
Contact information
Practice address
126 W MINERAL ST, MILWAUKEE, WI 53204-1844
(414) 270-1970
(414) 270-1971
Mailing address
126 W MINERAL ST, MILWAUKEE, WI 53204-1844
(414) 270-1970
(414) 270-1971
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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