MEDICARE: MSL HOME CARE, INC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1811392046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MSL HOME CARE, INC

Provider Business Mailing Address
First Line	:	830 N 109TH ST
Second Line	:	SUITE 27
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3754
Country	:	US
Telephone Number	:	414-282-8606
Fax Number	:	866-610-0629

Provider Business Practice Location Address
First Line	:	830 N 109TH ST
Second Line	:	SUITE 27
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3754
Country	:	US
Telephone Number	:	414-282-8606
Fax Number	:	866-610-0629

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL LAIRD
Credential	:
Telephone Number	:	414-282-8606

Provider Enumeration Date	:	10/30/2014
Last Update Date	:	10/30/2014

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