MEDICARE: NEHEMIAH HOUSE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1124634332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEHEMIAH HOUSE, LLC

Provider Business Mailing Address
First Line	:	5210 W HAMPTON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218
Country	:	US
Telephone Number	:	414-530-3612
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 N 21ST STREET
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206
Country	:	US
Telephone Number	:	414-312-7452
Fax Number	:	414-755-0655

Authorized Official
Title or Position	:	CEO
Name	:	MS. SANDRA F TAYLOR
Credential	:
Telephone Number	:	414-530-3612

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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Directions to “NEHEMIAH HOUSE, LLC ” Practice Location

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