Organization
LIFE TO LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE HUMPHRIE B.S (OWNER)
(414) 304-4883
Entity
Organization
Contact information
Practice address
1109 N MAYFAIR RD STE 202, WAUWATOSA, WI 53226-3430
(414) 304-4883
(414) 231-9899
Mailing address
1109 N MAYFAIR RD STE 202, WAUWATOSA, WI 53226-3430
(414) 304-4883
(414) 231-9899
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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