Healthcare Provider Details

I. General information

NPI: 1871415174
Provider Name (Legal Business Name): AUBREYS SUPPORTIVE CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4413 WEST HAMPTON AVENUE
MILWAUKEE WI
53209
US

IV. Provider business mailing address

4413 WEST HAMPTON AVENUE
MILWAUKEE WI
53209
US

V. Phone/Fax

Practice location:
  • Phone: 414-391-6712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LUCAS SMITH
Title or Position: FOUNDER
Credential:
Phone: 414-391-6712