Home of Roots and Grace LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HOME OF ROOTS AND GRACE LLC

Practice address

4683 N 74TH St
Milwaukee, WI 53218-4750

Phone

(414) 810-0057

Fax

(414) 810-0006

NPI assigned

Jan 28, 2026

Last updated

Mar 27, 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

Maria Abdalla, LPN

Title

Owner/Administrator

Phone

(414) 810-0057

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1528918828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4683 N 74TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184750",
            "telephone_number": "414-810-0057",
            "fax_number": "414-810-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4683 N 74TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184750",
            "telephone_number": "414-810-0057",
            "fax_number": "414-810-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME OF ROOTS AND GRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "ABDALLA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "414-810-0057",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "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 Mar 27, 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.