NPI 1477285484

Humble Living Adult Family Group Home LLC

Organisation Assisted Living Facility West Bend, WI

Practice location

Address: 1124 W Washington St, West Bend, WI 53095-2434
Phone: (262) 239-1138

Authorised official

Name: Vershaunda Campbell
Title: Owner
Phone: (262) 239-1138

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1477285484
Entity type: Organization
NPI issued: 28 Jun 2022
Record last updated: 28 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.