Healthcare Provider Details

I. General information

NPI: 1487526521
Provider Name (Legal Business Name): MAUDIE'S PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5132 N 60TH ST
MILWAUKEE WI
53218-4103
US

IV. Provider business mailing address

2925 RAPIDS DR
RACINE WI
53404-1622
US

V. Phone/Fax

Practice location:
  • Phone: 414-628-3433
  • Fax: 414-755-0646
Mailing address:
  • Phone: 414-628-3433
  • Fax: 414-755-0646

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 Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHERYL A NORAH
Title or Position: OWNER
Credential:
Phone: 414-628-3433