831 Adult Living Facility LLC
Organization Active NPI Assisted Living Facility · Milwaukee, WI
NPI 1972236974 · NPPES record last updated Jul 7, 2022
Key facts
- NPI
- 1972236974
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- 831 ADULT LIVING FACILITY LLC
- Practice address
- 5836 N 76TH St
Milwaukee, WI 53218-1836 - Phone
- (414) 248-2724
- NPI assigned
- Jul 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Mr. Demarvis D Johnson Sr.
- Title
- President
- Phone
- (414) 248-2724
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
5836 N 76TH St
Milwaukee, WI 53218-1836
Mailing address
5836 N 76TH St
Milwaukee, WI 53218-1836
Phone (414) 248-2724
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.