MEDICARE: PEACEFUL CARE LIVING LLC

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1891677050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEFUL CARE LIVING LLC

Provider Business Mailing Address
First Line	:	7843 W MILL RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-1147
Country	:	US
Telephone Number	:	414-236-5106
Fax Number	:	414-210-4437

Provider Business Practice Location Address
First Line	:	7843 W MILL RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-1147
Country	:	US
Telephone Number	:	414-236-5106
Fax Number	:	414-210-4437

Authorized Official
Title or Position	:	OWNER
Name	:	DANYALE WILDER
Credential	:
Telephone Number	:	262-395-9858

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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Directions to “PEACEFUL CARE LIVING LLC ” Practice Location

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