Organization
LE'DOVE AFH LLC
Active
Parent organization
LE'DOVE AFH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LE'DOVE AFH LLC
Authorized official
MRS. ETHEL LEE LOCKRIDGE (OWNER)
(262) 639-3253
Entity
Organization
Contact information
Practice address
724 MONTICELLO DR, RACINE, WI 53402-3006
(262) 639-3253
(262) 681-1174
Mailing address
724 MONTICELLO DR, RACINE, WI 53402-3006
(262) 639-3253
(262) 681-1174
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
WI
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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