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General NPI Number Information
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NPI Number | 1750549382
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Entity Type | Organization
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Legal Business Name | FAMILY HOUSE, INC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 3269 N 11TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53206-2828
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Country | US
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Telephone | 414-374-5212
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Fax | 414-374-1294
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Provider Business Mailing Address
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Address Line | 3269 N 11TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53206-2828
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Country | US
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Telephone | 414-374-5212
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Fax | 414-374-1294
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Authorized Official
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Title or Position | FINANCE MANGER
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Name | MR. LEONEL DODZI AC-LUMOR
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Credential |
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Telephone | 414-374-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6685-800
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License Number State | WI
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