MEDICARE: TONY'S HOME FOR US 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1619819943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TONY'S HOME FOR US LLC

Provider Business Mailing Address
First Line	:	4826 N 72ND ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3840
Country	:	US
Telephone Number	:	414-460-5551
Fax Number	:

Provider Business Practice Location Address
First Line	:	4826 N 72ND ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3840
Country	:	US
Telephone Number	:	414-460-5551
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE L PERRY
Credential	:
Telephone Number	:	414-460-5551

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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