Organization Active NPI

Presleys Second Home

  • Adult Care Home Facility
  • Milwaukee, WI
National Provider Identifier
1093641128
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
PRESLEYS SECOND HOME
Practice address
3069 N 52ND St
Milwaukee, WI 53210-1612
Phone
(414) 791-9929
NPI assigned
Jun 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Authorized official

Name
Mr. Lamont Ledell Johnson Sr.
Title
Owner/Ceo
Phone
(414) 791-9929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

3069 N 52ND St
Milwaukee, WI 53210-1612

Mailing address

3069 N 52ND St
Milwaukee, WI 53210-1612
Phone (414) 791-9929

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1093641128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 N 52ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101612",
            "telephone_number": "414-791-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3069 N 52ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101612",
            "telephone_number": "414-791-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESLEYS SECOND HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_middle_name": "LEDELL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "414-791-9929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.