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NPI Code Detail

MEDICARE: NELSON HOME HEALTH CARE NO 5 LLC

MEDICARE: NELSON HOME HEALTH CARE NO 5 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1710709720
Entity Type Code : Organization
Provider Name (Legal Business Name) : NELSON HOME HEALTH CARE NO 5 LLC
Provider Business Mailing Address
First Line : 7305 W CRAWFORD AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53220-1729
Country : US
Telephone Number : 414-212-8049
Fax Number : 262-533-8875
Provider Business Practice Location Address
First Line : 7764 W COLD SPRING RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53220-2817
Country : US
Telephone Number : 414-212-8049
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DORINA NELSON
Credential :
Telephone Number : 262-994-2780
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/30/2024

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Directions to “NELSON HOME HEALTH CARE NO 5 LLC ” Practice Location

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