Healthcare Provider Details

I. General information

NPI: 1861324824
Provider Name (Legal Business Name): NOBLEROOTS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E3586 N RIDGE RD
GENOA WI
54632-8895
US

IV. Provider business mailing address

E3586 N RIDGE RD
GENOA WI
54632-8895
US

V. Phone/Fax

Practice location:
  • Phone: 608-606-3776
  • Fax: 608-606-3776
Mailing address:
  • Phone: 608-606-3776
  • Fax: 608-606-3776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MARIE HANSON
Title or Position: OWNER
Credential:
Phone: 608-606-3776