Provider Demographics
NPI:1821842147
Name:DOROTHYS PLACE OF LIVING LLC
Entity Type:Organization
Organization Name:DOROTHYS PLACE OF LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYTIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLISH-SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-239-0635
Mailing Address - Street 1:4889 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5629
Mailing Address - Country:US
Mailing Address - Phone:414-239-0635
Mailing Address - Fax:
Practice Address - Street 1:4889 N 24TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5629
Practice Address - Country:US
Practice Address - Phone:414-239-0635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility