Healthcare Provider Details

I. General information

NPI: 1144194564
Provider Name (Legal Business Name): FAMILY ONE CARE SERVICES OF WISCONSIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 N 26TH ST
MILWAUKEE WI
53233-1508
US

IV. Provider business mailing address

814 N 26TH ST
MILWAUKEE WI
53233-1508
US

V. Phone/Fax

Practice location:
  • Phone: 414-207-4560
  • Fax: 414-448-6946
Mailing address:
  • Phone: 414-207-4560
  • Fax: 414-448-6946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TAWAN J BOWLING
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential:
Phone: 414-378-9375