Organization · NPI-2

Bailey Rose Adult Family Home LLC

Assisted Living Facility, Assisted Living, Mental Illness · Racine, WI

NPI number1487386355
StatusActive
Last updated in NPPESJun 28, 2022

Details

NPI
1487386355
Entity type
Organization (NPI-2)
Legal business name
Bailey Rose Adult Family Home LLC
Organization subpart
No
Enumeration date
Jun 28, 2022
Certification date
Jun 28, 2022
Last updated
Jun 28, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness––Yes

Practice location

4800 Kinzie Ave
Racine, WI 53406-4124

Phone 262-664-9233 · Fax 262-886-8112

Mailing address

4800 Kinzie Ave
Racine, WI 53406-4124

Phone 262-664-9233 · Fax 262-886-8112

Authorized official

Tamara Young
Owner
2626649233

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