Healthcare Provider Details

I. General information

NPI: 1295432698
Provider Name (Legal Business Name): GENTLE JOURNEY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 N 18TH ST
MILWAUKEE WI
53209-6826
US

IV. Provider business mailing address

4208 N 18TH ST
MILWAUKEE WI
53209-6826
US

V. Phone/Fax

Practice location:
  • Phone: 262-799-2678
  • Fax:
Mailing address:
  • Phone: 262-799-2678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LATARSHA CARTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 262-799-2678