MEDICARE: A GIFT FROM THE HEART LLC

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
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1245091545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A GIFT FROM THE HEART LLC

Provider Business Mailing Address
First Line	:	5263 N 65TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3009
Country	:	US
Telephone Number	:	262-230-7687
Fax Number	:

Provider Business Practice Location Address
First Line	:	5263 N 65TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3009
Country	:	US
Telephone Number	:	262-230-7687
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SHECORI BURNS
Credential	:
Telephone Number	:	262-230-7687

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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Directions to “A GIFT FROM THE HEART LLC ” Practice Location

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