Healthcare Provider Details

I. General information

NPI: 1326988577
Provider Name (Legal Business Name): GIFTED CARE ADULT FAMILY HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10328 W VILLA AVE
MILWAUKEE WI
53224-2655
US

IV. Provider business mailing address

790 N MILWAUKEE ST STE 302
MILWAUKEE WI
53202-4073
US

V. Phone/Fax

Practice location:
  • Phone: 414-446-4306
  • Fax: 414-446-4306
Mailing address:
  • Phone: 414-248-5133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES ANDREW HEGWOOD JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 414-248-5133