MEDICARE: EMORYS RESIDENTIAL 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1922953918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMORYS RESIDENTIAL LIVING LLC

Provider Business Mailing Address
First Line	:	2210 W VIENNA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1959
Country	:	US
Telephone Number	:	414-375-5226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 W VIENNA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1959
Country	:	US
Telephone Number	:	414-375-5226
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRASHAYA ADORE HILL
Credential	:
Telephone Number	:	414-375-5226

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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