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Organization

ROYAL LEGACY ADULT FAMILY HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LADIAMA JOHNSON (OWNER)
(414) 915-6323
Entity
Organization

Contact information

Practice address
1922 N 37TH ST, MILWAUKEE, WI 53208-1801
(414) 436-9201
Mailing address
1922 N 37TH ST, MILWAUKEE, WI 53208-1801
(414) 436-9201

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
05/13/2016
Last updated
05/13/2016
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