Healthcare Provider Details

I. General information

NPI: 1013833078
Provider Name (Legal Business Name): BH LEGACY IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 N 21ST ST
MILWAUKEE WI
53206-1632
US

IV. Provider business mailing address

2975 N 21ST ST
MILWAUKEE WI
53206-1632
US

V. Phone/Fax

Practice location:
  • Phone: 414-403-5595
  • Fax:
Mailing address:
  • Phone:
  • Fax: 414-403-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TINA ALEXIS PIRTLE
Title or Position: OWNER
Credential:
Phone: 414-403-5595