Healthcare Provider Details

I. General information

NPI: 1639944713
Provider Name (Legal Business Name): NEXT LEVEL HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W SILVER SPRING DR STE K200
GLENDALE WI
53217-5052
US

IV. Provider business mailing address

500 W SILVER SPRING DR
GLENDALE WI
53217-5051
US

V. Phone/Fax

Practice location:
  • Phone: 262-735-5822
  • Fax:
Mailing address:
  • Phone: 262-735-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JULIAN MACKEY SR.
Title or Position: CEO
Credential:
Phone: 262-735-5822