Provider Demographics
NPI:1245121730
Name:WILLIAMS, JUSTICE
Entity type:Individual
Prefix:
First Name:JUSTICE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4573 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5909
Mailing Address - Country:US
Mailing Address - Phone:262-278-9997
Mailing Address - Fax:262-278-9997
Practice Address - Street 1:4573 N 37TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5909
Practice Address - Country:US
Practice Address - Phone:262-278-9997
Practice Address - Fax:262-278-9997
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home