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Tiffany Powell
Adult Care Home Facility in Kenosha, Wisconsin
NPI 1992495618

Tiffany Powell is an Adult Care Home Facility based in Kenosha, WI and is specialized in Adult Care Home. Tiffany Powell practices in Kenosha, WI. The NPI Number for Tiffany Powell is 1992495618 and holds a License No. 0016623 (Wisconsin).

The current practice location address for Tiffany Powell is 4047 32Nd Ave, Kenosha, WI and can be reached out via phone at 262-914-2216. You can also correspond with Tiffany Powell through the mailing address at 6815 32ND AVE, KENOSHA, WI - 53142-3447 (mailing address contact number: 262-914-2216).

Location: 4047 32Nd Ave, Kenosha, WI, 53142-3447
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992495618
Provider Name
Tiffany Powell
Credential
Provider Entity Type
Individual
Gender
Female
Address
4047 32Nd Ave, Kenosha, WI, 53142-3447
Phone Number
262-914-2216
Fax Number
Provider Enumeration Date
05/08/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4047 32Nd Ave
City
Kenosha
State
Wisconsin
Zip
53144-1914
Phone Number
262-914-2216
Fax Number
person
Provider Business Mailing Address Details
Address
4047 32Nd Ave
City
Kenosha
State
Wisconsin
Zip
53144-1914
Phone Number
262-914-2216
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
0016623 (Wisconsin)
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
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