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General NPI Number Information
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NPI Number | 1548051253
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Entity Type | Organization
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Legal Business Name | AGRACE MILWAUKEE LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 933 N MAYFAIR RD STE 109
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City | WAUWATOSA
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State | WI
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Zip | 53226-3432
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Country | US
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Telephone | 608-276-4660
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Fax |
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Provider Business Mailing Address
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Address Line | 5395 E CHERYL PKWY
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City | FITCHBURG
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State | WI
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Zip | 53711-5395
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Country | US
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Telephone | 608-276-4660
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LYNNE SEXTEN
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Credential |
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Telephone | 608-276-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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