Healthcare Provider Details

I. General information

NPI: 1023948221
Provider Name (Legal Business Name): AS WE GROW ADULT FAMILY HOME 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825A S SILVERBROOK DR
WEST BEND WI
53095-3874
US

IV. Provider business mailing address

PO BOX 80019
SAUKVILLE WI
53080-0019
US

V. Phone/Fax

Practice location:
  • Phone: 414-554-8581
  • Fax: 262-710-8835
Mailing address:
  • Phone: 414-554-8581
  • Fax: 262-710-8835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS MCCARTY
Title or Position: OWNER
Credential:
Phone: 414-554-8581