Clean Slate Adult Family Home Corp
Clean Slate Adult Family Home Corp is an Adult Care Home Facility in Milwaukee, Wisconsin. Registered with an NPI since 2024.
- In the registry since
- 2024
What do these letters mean?
- Corp — Corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
5102 N 77th StMilwaukee, WI 53218-3701
Phone: (414) 616-1668
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Care Home Facility (primary) | Taxonomy 311ZA0620X |
|---|
Record details
| NPI number | 1598581647 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tyrone Simmon — Owner · (630) 234-4783 |
| NPI enumerated | November 22, 2024 |
| Last updated in NPPES | November 22, 2024 |
| Certification date | November 22, 2024 |
| Mailing address | 5743 N 77th St, Milwaukee, WI 53218-2144 |
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