Clean Slate Adult Family Home Corp.
NPI 1104681238 · Adult Care Home Facility · Milwaukee, WI
Clean Slate Adult Family Home Corp. is a Adult Care Home Facility organization in Milwaukee, WI (NPI 1104681238).
Provider details
- NPI number
- 1104681238
- Entity type
- Organization
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Tyrone Simmons, Owner(630) 234-4783
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-02-19
- Last updated
- 2024-11-22
- Certified
- 2024-11-22
Frequently asked questions
- What is Clean Slate Adult Family Home Corp.'s NPI number?
- Clean Slate Adult Family Home Corp.'s National Provider Identifier (NPI) is 1104681238, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Clean Slate Adult Family Home Corp.?
- Clean Slate Adult Family Home Corp. is classified in the NPPES registry as Adult Care Home Facility (Nursing & Custodial Care Facilities).
- Where is Clean Slate Adult Family Home Corp. located?
- Clean Slate Adult Family Home Corp.'s practice location on file with NPPES is 5743 N 77th St, Milwaukee, WI 53218-2144.
- What is Clean Slate Adult Family Home Corp.'s phone number?
- The practice phone number listed in the NPPES registry for Clean Slate Adult Family Home Corp. is (262) 804-0099.
- Who is the authorized official for Clean Slate Adult Family Home Corp.?
- The authorized official listed on Clean Slate Adult Family Home Corp.'s NPPES record is Tyrone Simmons, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Clean Slate Adult Family Home Corp.'s NPI active?
- Yes — Clean Slate Adult Family Home Corp.'s NPI (1104681238) is active in the NPPES registry as of the last update on 2024-11-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.