Healthcare Provider Details

I. General information

NPI: 1104665785
Provider Name (Legal Business Name): BASMA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 INTERNATIONAL LN STE 101
MADISON WI
53704-3100
US

IV. Provider business mailing address

2917 INTERNATIONAL LN STE 101
MADISON WI
53704-3100
US

V. Phone/Fax

Practice location:
  • Phone: 608-665-0897
  • Fax:
Mailing address:
  • Phone: 608-556-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABDIQADIR A MOHAMED
Title or Position: PROGRAM DIRECTOR
Credential: ADC#0021062
Phone: 608-665-0897