1 Heavenly Divine Adult Family Homes LLC
Custodial Care Facility, Adult Care Home in Milwaukee, WI. Organization (NPI-2).
NPI number1952051211
StatusActive
Last updated in NPPESJul 10, 2025
Details
- NPI
- 1952051211
- Entity type
- Organization (NPI-2)
- Legal business name
- 1 Heavenly Divine Adult Family Homes LLC
- Organization subpart
- No
- Enumeration date
- Mar 28, 2022
- Certification date
- Jul 10, 2025
- Last updated
- Jul 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
| 310400000X | Assisted Living Facility | – | – |
Other names
- Kathy Jones (Former Legal Business Name)
Practice location
4637 N 24th PlMilwaukee, WI 53209-6206
Phone 414-350-3558 · Fax 414-979-0092
Mailing address
Po Box 16545Milwaukee, WI 53216-0545
Phone 414-350-3558 · Fax 414-979-0092
Authorized official
Kathy Jones
Owner
4143503558
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