Organization
GUARDIAN GRACE RESIDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LADASHIA CANNON (OWNER)
(414) 460-1400
Entity
Organization
Contact information
Practice address
6925 N DARIEN ST, MILWAUKEE, WI 53209-2412
(414) 460-1400
Mailing address
6925 N DARIEN ST, MILWAUKEE, WI 53209-2412
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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