| Home Away From Home Living Services Llc | |
|
8127 W Herbert Ave Milwaukee WI 53218-3632 | |
| (414) 881-4185 | |
| Not Available |
| Full Name | Home Away From Home Living Services Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 8127 W Herbert Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Latoya Lacole Christian (CEO) |
| Authorized Official Contact | 4148814185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home Away From Home Living Services Llc Po Box 76668 Milwaukee WI 53216-8268 Ph: (414) 881-4185 | Home Away From Home Living Services Llc 8127 W Herbert Ave Milwaukee WI 53218-3632 Ph: (414) 881-4185 |
| NPI Number | 1730530239 |
|---|---|
| Provider Enumeration Date | 06/26/2016 |
| Last Update Date | 06/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730530239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 0015974 (Wisconsin) | Primary |
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