Heart of Lynn Adult Family Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

HEART OF LYNN ADULT FAMILY HOME

Practice address

9617 W Goodrich Ave
Milwaukee, WI 53224-2735

Phone

(414) 394-1049

NPI assigned

Sep 30, 2026

Last updated

Sep 30, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Destiny Polk

Title

Owner

Phone

(414) 394-1049

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1467366039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 N 73RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9617 W GOODRICH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532242735",
            "telephone_number": "414-394-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF LYNN ADULT FAMILY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-394-1049"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.