Healthcare Provider Details

I. General information

NPI: 1629071121
Provider Name (Legal Business Name): COMMONHEART, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N16W23217 STONE RIDGE DR STE 350
WAUKESHA WI
53188-1171
US

IV. Provider business mailing address

N16W23217 STONE RIDGE DR STE 350
WAUKESHA WI
53188-1171
US

V. Phone/Fax

Practice location:
  • Phone: 844-206-4930
  • Fax: 920-261-4840
Mailing address:
  • Phone: 844-206-4930
  • Fax: 920-261-4840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number134
License Number StateWI

VIII. Authorized Official

Name: JUSTIN MUNZEL
Title or Position: PRESIDENT
Credential:
Phone: 920-328-1029