Healthcare Provider Details

I. General information

NPI: 1609625557
Provider Name (Legal Business Name): CLEAR PATH PERSONAL CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10920 W LINCOLN AVE STE D
WEST ALLIS WI
53227-1130
US

IV. Provider business mailing address

10920 W LINCOLN AVE STE D
WEST ALLIS WI
53227-1130
US

V. Phone/Fax

Practice location:
  • Phone: 262-456-0350
  • Fax: 262-578-0070
Mailing address:
  • Phone: 262-456-0350
  • Fax: 262-578-0070

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RONALD M BELL JR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 262-456-0350