Healthcare Provider Details

I. General information

NPI: 1144950478
Provider Name (Legal Business Name): DASHIA JACKSON-DAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5371 N 51ST BLVD
MILWAUKEE WI
53218-3304
US

IV. Provider business mailing address

10134 N PORT WASHINGTON RD
MEQUON WI
53092-5700
US

V. Phone/Fax

Practice location:
  • Phone: 262-888-9530
  • Fax:
Mailing address:
  • Phone: 262-888-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: