Healthcare Provider Details

I. General information

NPI: 1073799953
Provider Name (Legal Business Name): ASSISTED DAILY LIVING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 N WAVERLY PL
MILWAUKEE WI
53202-3480
US

IV. Provider business mailing address

1121 N WAVERLY PL
MILWAUKEE WI
53202-3480
US

V. Phone/Fax

Practice location:
  • Phone: 414-271-5500
  • Fax:
Mailing address:
  • Phone: 414-271-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. GLENN E JOHNSTON
Title or Position: DIRECTOR
Credential:
Phone: 414-271-5500