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Organization

TIMELESS MANOR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAYMIA/ TEMEKO PUTZEAR/ KNOWLWS (OWNWER)
(414) 239-3274
Entity
Organization

Contact information

Practice address
3304 INDIANA ST, MT PLEASANT, WI 53405-4616
(414) 239-3274
Mailing address
3304 INDIANA ST, MT PLEASANT, WI 53405-4616

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100324691
WI
Enumeration date
08/01/2025
Last updated
08/01/2025
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