MEDICARE: WICARE PERSONAL CARE AGENCY

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1780519579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WICARE PERSONAL CARE AGENCY

Provider Business Mailing Address
First Line	:	3724 N 39TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3068
Country	:	US
Telephone Number	:	414-477-9770
Fax Number	:

Provider Business Practice Location Address
First Line	:	3724 N 39TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3068
Country	:	US
Telephone Number	:	414-477-9770
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DESTINEY SCALES
Credential	:
Telephone Number	:	414-477-9770

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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