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General NPI Number Information
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NPI Number | 1528938719
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Entity Type | Organization
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Legal Business Name | JCEAL5
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | N95W18419 COUNTY LINE RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-7101
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Country | US
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Telephone | 262-799-5931
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Fax | 262-799-4062
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Provider Business Mailing Address
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Address Line | N95W18419 COUNTY LINE RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-7101
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Country | US
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Telephone | 262-799-5931
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Fax | 262-799-4062
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSH G WALTERS
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Credential |
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Telephone | 262-347-8801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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