Healthcare Provider Details

I. General information

NPI: 1780519579
Provider Name (Legal Business Name): WICARE PERSONAL CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3724 N 39TH ST
MILWAUKEE WI
53216-3068
US

IV. Provider business mailing address

3724 N 39TH ST
MILWAUKEE WI
53216-3068
US

V. Phone/Fax

Practice location:
  • Phone: 414-477-9770
  • Fax:
Mailing address:
  • Phone: 414-477-9770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: DESTINEY SCALES
Title or Position: OWNER
Credential:
Phone: 414-477-9770