Healthcare Provider Details

I. General information

NPI: 1912815481
Provider Name (Legal Business Name): FADIE'S HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W BROWN DEER RD STE 211
MILWAUKEE WI
53223-1710
US

IV. Provider business mailing address

3266 N 54TH ST
MILWAUKEE WI
53216-3104
US

V. Phone/Fax

Practice location:
  • Phone: 262-293-6887
  • Fax: 262-364-2336
Mailing address:
  • Phone: 262-293-6887
  • Fax: 262-364-2336

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: DEANNA CARSON
Title or Position: OWNER
Credential:
Phone: 262-293-6887