Organization
5 GOODMEN COMMUNITY CARE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE WEAVER B.A DEGREE (COO)
(414) 309-2740
Entity
Organization
Contact information
Practice address
942 N 29TH ST, MILWAUKEE, WI 53208-3406
(414) 988-5321
Mailing address
942 N 29TH ST, MILWAUKEE, WI 53208-3406
(414) 988-5321
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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