Healthcare Provider Details

I. General information

NPI: 1790869766
Provider Name (Legal Business Name): HOMEWARD BOUND HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W MAPLE ST STE 2
LANCASTER WI
53813-1642
US

IV. Provider business mailing address

130 WEST ELM STREET P.O. BOX 503
LANCASTER WI
53813-0503
US

V. Phone/Fax

Practice location:
  • Phone: 608-723-6601
  • Fax: 608-723-6616
Mailing address:
  • Phone: 608-723-6601
  • Fax: 608-723-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number330
License Number StateWI

VIII. Authorized Official

Name: KATHRYN A MILES
Title or Position: OWNER/DIRECTOR
Credential: RN
Phone: 608-723-6601