MEDICARE: P.R.O.M.I.S.E HOME HEALTHCARE 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	:	1861387094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P.R.O.M.I.S.E HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 250276
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53225-6502
Country	:	US
Telephone Number	:	414-451-8658
Fax Number	:	414-312-8313

Provider Business Practice Location Address
First Line	:	5600 W FOND DU LAC AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1222
Country	:	US
Telephone Number	:	414-451-8658
Fax Number	:	414-312-8313

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	ASEANTI N CALHOUN
Credential	:	BSN-RN
Telephone Number	:	414-451-8658

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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