Healthcare Provider Details

I. General information

NPI: 1033040100
Provider Name (Legal Business Name): CARING ANGELS SUPPORTIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4718 N 40TH ST
MILWAUKEE WI
53209-5812
US

IV. Provider business mailing address

4718 N 40TH ST
MILWAUKEE WI
53209-5812
US

V. Phone/Fax

Practice location:
  • Phone: 414-940-0245
  • Fax:
Mailing address:
  • Phone: 414-940-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARQUITA CLAY
Title or Position: LPN
Credential: NURSE
Phone: 414-940-0245