Organization
GRACE PERSONAL CARE SERVICES, LLC
Active
Other names
Grace Supportive Living Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANTONA T THORNTON RN (DIRECTOR)
(414) 336-5556
Entity
Organization
Contact information
Practice address
3246 N TEUTONIA AVE, MILWAUKEE, WI 53206-2265
(414) 336-5556
(414) 264-4825
Mailing address
PO BOX 06221, MILWAUKEE, WI 53206-0221
(414) 336-5556
(414) 264-4825
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100011394
—
WI
Enumeration date
02/24/2011
Last updated
02/24/2011
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