Healthcare Provider Details

I. General information

NPI: 1164359600
Provider Name (Legal Business Name): LIVINGWELL HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12665 W NORTH AVE
BROOKFIELD WI
53005-4629
US

IV. Provider business mailing address

12665 W NORTH AVE
BROOKFIELD WI
53005-4629
US

V. Phone/Fax

Practice location:
  • Phone: 262-505-6585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YVETTE FORD-LEWIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 262-212-2612