JIMMIE C GRAYS, Adult Care Home SOUTH MILWAUKEE, WI

Contact Information

JIMMIE C GRAYS

2903 15TH AVE
SOUTH MILWAUKEE, WI 53172-3031

Phone: 262-497-8448
Fax: 262-681-3118
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Adult Care Home	311ZA0620X
Custodial Care Facility	311Z00000X

Indicates primary specialty

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NPI Profile & details for JIMMIE C GRAYS · (Male)

NPI Number	`1750276077`
Status	Active
Credentials
Entity	Individual
Enumeration date	06/09/2025
Last updated	06/09/2025 - About 12 months ago
Sole proprietor ¹	Yes
Identifiers	WI License # 0014387
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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