Healthcare Provider Details

I. General information

NPI: 1417860768
Provider Name (Legal Business Name): BESTOW SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 N 41ST ST
MILWAUKEE WI
53210-2935
US

IV. Provider business mailing address

2505 N 41ST ST
MILWAUKEE WI
53210-2935
US

V. Phone/Fax

Practice location:
  • Phone: 414-788-1084
  • Fax: 862-263-7319
Mailing address:
  • Phone: 414-788-1084
  • Fax: 862-263-7319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICOLE JACKSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 414-788-1084