MEDICARE: LOVE WITH A PURPOSE RESIDENTIAL 2

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1770447096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE WITH A PURPOSE RESIDENTIAL 2

Provider Business Mailing Address
First Line	:	4723 N SHERMAN BLVD APT 2
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-5837
Country	:	US
Telephone Number	:	262-458-8431
Fax Number	:

Provider Business Practice Location Address
First Line	:	4723 N SHERMAN BLVD APT 2
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-5837
Country	:	US
Telephone Number	:	262-458-8431
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. TAMIRA LANISHA MAJOR
Credential	:
Telephone Number	:	262-458-8431

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “LOVE WITH A PURPOSE RESIDENTIAL 2 ” Practice Location

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