Jean-Owen Adult Family Home, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

0016231 Issued in WI

Legal business name

JEAN-OWEN ADULT FAMILY HOME, LLC

Practice address

1423 Rawson Ave
South Milwaukee, WI 53172-1940

Phone

(414) 215-7953

NPI assigned

Feb 28, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Michelle Renee Washington

Title

Owner

Phone

(414) 588-6766

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1033611678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531720293",
            "telephone_number": "414-215-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 RAWSON AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531721940",
            "telephone_number": "414-215-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN-OWEN ADULT FAMILY HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-588-6766",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WI",
            "license": "0016231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.