MEDICARE: COZY AURORA ADULT FAMILY HOME 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
2	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1992528244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COZY AURORA ADULT FAMILY HOME LLC

Provider Business Mailing Address
First Line	:	2054 KEARNEY AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-2462
Country	:	US
Telephone Number	:	262-939-3666
Fax Number	:

Provider Business Practice Location Address
First Line	:	2719 MARYLAND AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-3743
Country	:	US
Telephone Number	:	262-939-3666
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	PARIT PATEL
Credential	:
Telephone Number	:	262-939-3666

Provider Enumeration Date	:	11/05/2024
Last Update Date	:	12/01/2025

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