Organization · NPI-2

Abundant Homes For Independent LLC

Custodial Care Facility, Adult Care Home · Milwaukee, WI

NPI number1992539969
StatusActive
Last updated in NPPESAug 30, 2024

Details

NPI
1992539969
Entity type
Organization (NPI-2)
Legal business name
Abundant Homes For Independent LLC
Organization subpart
No
Enumeration date
Aug 30, 2024
Certification date
Aug 30, 2024
Last updated
Aug 30, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
311ZA0620X Custodial Care Facility, Adult Care Home––Yes

Practice location

4645 N 46th St
Milwaukee, WI 53218-5210

Phone 414-616-1180 · Fax 414-662-5203

Mailing address

4645 N 46th St
Milwaukee, WI 53218-5210

Phone 414-616-1180 · Fax 414-662-5203

Authorized official

Shyvon Metcalf
Director
4147370335

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