Organization
ALL FOR 1 PHASE 1 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DETRA EVON FERGUSON (CEO)
(414) 213-3966
Entity
Organization
Contact information
Practice address
12700 W CLEVELAND AVE, NEW BERLIN, WI 53151-4008
(414) 236-5660
(414) 755-7676
Mailing address
7101 N GREEN BAY AVE STE 7, GLENDALE, WI 53209-2800
(414) 236-5660
(414) 755-7676
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
12/04/2025
Last updated
12/05/2025
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