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Organization

EASY LIVING SENIOR HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CARMEN MARTIN RN-BC (PRESIDENT)
(414) 702-5573
Entity
Organization

Contact information

Practice address
7219 W MEDFORD AVE, MILWAUKEE, WI 53218-3833
(414) 393-1015
(414) 435-1620
Mailing address
7414 W HAMPTON AVE, MILWAUKEE, WI 53218-4746
(414) 702-5573
(414) 435-1620

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary

Other

Enumeration date
04/01/2026
Last updated
04/01/2026
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