Med Group Adult Day Care of Wi, LLC
NPI #1437409737 in Hales Corners, Wisconsin
Provider Information
- NPI Number
- 1437409737
- Entity Type
- Organization
- Organization Name
- Med Group Adult Day Care of Wi, LLC
- Primary Specialty
- Custodial Care Facility
- Enumeration Date
- Sep 13, 2012
- Last Updated
- Sep 13, 2012
Practice Location
- Address
- 10549 W FOREST HOME AVE
- City
- Hales Corners
- State
- Wisconsin
- ZIP Code
- 53130-2057
- Phone
- (414) 755-0558
Authorized Official
- Name
- DARIKO MEKVABISHVILI
- Title
- PRESIDENT
- Phone
- (414) 755-0558
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility |
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