MEDICARE: PREH REH

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	253Z00000X	In Home Supportive Care Agency		WI

General Provider Information

NPI Number	:	1407713423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREH REH

Provider Business Mailing Address
First Line	:	4036 S 5TH PL
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-4336
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4036 S 5TH PL
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-4336
Country	:	US
Telephone Number	:	336-341-0203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	05/27/2026

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Directions to “ PREH REH ” Practice Location

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