Organization
GWENMAR LLC
Active
Other names
GwenMar LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWENLODYN MOSS (OWNER)
(414) 699-3518
Entity
Organization
Contact information
Practice address
4230 N 53RD ST, MILWAUKEE, WI 53216-1343
(414) 699-3518
(520) 423-3901
Mailing address
4230 N 53RD ST, MILWAUKEE, WI 53216-1343
(414) 699-3518
(520) 423-3901
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
—
—
385HR2055X
Child Mental Illness Respite Care
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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