Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jimmie C Grays

Individual provider Adult Care Home Facility · NPI 1750276077

Jimmie C Grays is an Adult Care Home Facility in South Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2025
Specialties on file
2

Practice location Address checks out

2903 15th Ave
South Milwaukee, WI 53172-3031
Phone: (262) 497-8448
Fax: (262) 681-3118
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Care Home Facility (primary) Taxonomy 311ZA0620X · Licence 0014387 (WI)
Custodial Care Facility Taxonomy 311Z00000X · Licence 0014387 (WI)

Record details

NPI number1750276077
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 9, 2025
Last updated in NPPESJune 9, 2025
Certification dateJune 9, 2025
Mailing address5221 Gallant Fox Ln, Caledonia, WI 53402-6100

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