MEDICARE: BUILDING NEW PATHWAYS, 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	:	1922461383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUILDING NEW PATHWAYS, LLC

Provider Business Mailing Address
First Line	:	342 N WATER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-5514
Country	:	US
Telephone Number	:	414-690-8024
Fax Number	:	262-364-2901

Provider Business Practice Location Address
First Line	:	342 N WATER ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-5514
Country	:	US
Telephone Number	:	414-690-8024
Fax Number	:	262-364-2901

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SIERIA PAYNE
Credential	:
Telephone Number	:	414-690-8024

Provider Enumeration Date	:	04/03/2016
Last Update Date	:	04/03/2016

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Directions to “BUILDING NEW PATHWAYS, LLC ” Practice Location

Language	Start Address	Practice Location

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