Healthcare Provider Details

I. General information

NPI: 1306463393
Provider Name (Legal Business Name): L & L ANCHORAGE HOMES ADULT DAY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6435 W CAPITOL DR
MILWAUKEE WI
53216-2140
US

IV. Provider business mailing address

5340 W MELVINA ST
MILWAUKEE WI
53216-2218
US

V. Phone/Fax

Practice location:
  • Phone: 414-885-2765
  • Fax: 414-885-2766
Mailing address:
  • Phone: 414-550-8098
  • Fax: 414-875-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LUREAN LEA NELSON SLOCUM
Title or Position: DIRECTOR
Credential: REGISTERED NURSE
Phone: 414-550-8098