Healthcare Provider Details

I. General information

NPI: 1053118695
Provider Name (Legal Business Name): DENNIS COBB & HARRIS HEALTHCARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12005 W DOUGLAS AVE
MILWAUKEE WI
53225-1034
US

IV. Provider business mailing address

12005 W DOUGLAS AVE
MILWAUKEE WI
53225-1034
US

V. Phone/Fax

Practice location:
  • Phone: 414-426-4065
  • Fax:
Mailing address:
  • Phone: 414-426-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALECIA DENNIS
Title or Position: OWNER
Credential: RN
Phone: 414-426-4065