Healthcare Provider Details

I. General information

NPI: 1912901562
Provider Name (Legal Business Name): REGAL HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11805 W HAMPTON AVE STE 100
MILWAUKEE WI
53225-3612
US

IV. Provider business mailing address

11805 W HAMPTON AVE STE 100
MILWAUKEE WI
53225-3612
US

V. Phone/Fax

Practice location:
  • Phone: 414-355-7801
  • Fax: 414-355-7802
Mailing address:
  • Phone: 414-355-7801
  • Fax: 414-355-7802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1032
License Number StateWI

VIII. Authorized Official

Name: SIXTUS AGUWA
Title or Position: PRESIDENT
Credential:
Phone: 414-355-7801