MEDICARE: BESTCARE RESIDENCE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1851149488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BESTCARE RESIDENCE LLC

Provider Business Mailing Address
First Line	:	980 BRUCE ST
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-1084
Country	:	US
Telephone Number	:	612-282-1818
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 BRUCE ST
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-1084
Country	:	US
Telephone Number	:	612-282-1818
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	AHMED ABDI
Credential	:
Telephone Number	:	612-282-1818

Provider Enumeration Date	:	05/08/2024
Last Update Date	:	06/11/2026

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