Organization
HOME AWAY FROM HOME LIVING SERVICES LLC
Active
Organization
HOME AWAY FROM HOME LIVING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYA LACOLE CHRISTIAN (CEO)
(414) 881-4185
Entity
Organization
Contact information
Practice address
8127 W HERBERT AVE, MILWAUKEE, WI 53218-3632
(414) 881-4185
Mailing address
PO BOX 76668, MILWAUKEE, WI 53216-8268
(414) 881-4185
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
0015974
WI
Other
Enumeration date
06/26/2016
Last updated
06/26/2016
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