Organization
MOORE TRANQUILITY HOME LIVING LL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONIKA D MOORE ADULT FAMILY HOME (OWNER)
(414) 346-6498
Entity
Organization
Contact information
Practice address
5653 N 36TH ST, MILWAUKEE, WI 53209-4005
(414) 346-6498
Mailing address
5653 N 36TH ST, MILWAUKEE, WI 53209-4005
(414) 346-6498
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100368515
—
WI
Enumeration date
09/22/2025
Last updated
09/22/2025
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