Individual
JIMMIE C GRAYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2903 15TH AVE, SOUTH MILWAUKEE, WI 53172-3031
(262) 497-8448
(262) 681-3118
Mailing address
5221 GALLANT FOX LN, CALEDONIA, WI 53402-6100
(262) 497-8448
(262) 497-8448
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
0014387
WI
311ZA0620X
Adult Care Home Facility
Primary
0014387
WI
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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