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Organization

FAMILYLIVINGLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GWENDOLYN LACHELLE JONES (DIRECTOR)
(414) 354-7004
Entity
Organization

Contact information

Practice address
9120 N 94TH ST, MILWAUKEE, WI 53224-1705
(414) 354-7004
Mailing address
9120 N 94TH ST, MILWAUKEE, WI 53224-1705
(414) 354-7004

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
0013975
WI

Other

Enumeration date
04/09/2012
Last updated
04/09/2012
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