Healthcare Provider Details

I. General information

NPI: 1225556186
Provider Name (Legal Business Name): HOME AT HEART PERSONAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 07/21/2022
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 WEST BURLEIGH STREET
MILWAUKEE WI
53222
US

IV. Provider business mailing address

7720 WEST BURLEIGH STREET
MILWAUKEE WI
53222-4351
US

V. Phone/Fax

Practice location:
  • Phone: 414-635-7382
  • Fax:
Mailing address:
  • Phone: 414-635-7382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMIYA ALLISON
Title or Position: ADMINISTRATION
Credential:
Phone: 262-653-0055