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NPI Code Detail

MEDICARE: SPRING CARE ADULT FAMILY HOME

MEDICARE: SPRING CARE ADULT FAMILY HOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1311ZA0620XAdult Care Home Facility

General Provider Information

NPI Number : 1043176464
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING CARE ADULT FAMILY HOME
Provider Business Mailing Address
First Line : 8630 W SILVER SPRING DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53225-2845
Country : US
Telephone Number : 414-699-9034
Fax Number :
Provider Business Practice Location Address
First Line : 8630 W SILVER SPRING DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53225-2845
Country : US
Telephone Number : 414-699-9034
Fax Number :
Authorized Official
Title or Position : OWNER
Name : IYAKU TERRELL-RUSS
Credential : APNP
Telephone Number : 414-699-9034
Provider Enumeration Date : 12/30/2025
Last Update Date : 12/30/2025

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Directions to “SPRING CARE ADULT FAMILY HOME ” Practice Location

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