Healthcare Provider Details

I. General information

NPI: 1528854932
Provider Name (Legal Business Name): SHEA HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 W LINCOLN AVE # 22A
WEST ALLIS WI
53227-2300
US

IV. Provider business mailing address

9330 W LINCOLN AVE # 22A
WEST ALLIS WI
53227-2300
US

V. Phone/Fax

Practice location:
  • Phone: 414-635-0009
  • Fax:
Mailing address:
  • Phone: 414-635-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: TAMEIKA ROBINSON
Title or Position: OWNER
Credential: RN BSW
Phone: 414-803-7942