Southern Hope Homes LLC
Custodial Care Facility, Adult Care Home in Kenosha, WI. Organization (NPI-2).
NPI number1619783370
StatusActive
Last updated in NPPESDec 7, 2024
Details
- NPI
- 1619783370
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Hope Homes LLC
- Organization subpart
- No
- Enumeration date
- Dec 7, 2024
- Certification date
- Dec 7, 2024
- Last updated
- Dec 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
Practice location
3511 59th StKenosha, WI 53144-4133
Phone 262-577-5155
Mailing address
Po Box 855Kenosha, WI 53141-0855
Phone 262-960-2642
Authorized official
Norris Lynn Jones
Owner
2629602742
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