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General NPI Number Information
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NPI Number | 1659553121
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Entity Type | Organization
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Legal Business Name | BETTER LIVING GROUP HOME LLC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 4115 N 36TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53210
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Country | US
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Telephone | 414-871-1515
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Fax | 414-871-1503
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Provider Business Mailing Address
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Address Line | 4115 N 56TH ST SUITE B,188
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City | MILWAUKEE
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State | WI
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Zip | 53216-1269
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Country | US
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Telephone | 414-871-1515
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Fax | 414-871-1503
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. THOMAS SMITH
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Credential |
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Telephone | 414-975-5971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | WI
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