MEDICARE: HELEN HANDS ADULT FAMILY HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3104A0625X	Assisted Living Facility (Mental Illness)
2	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
3	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
4	385H00000X	Respite Care
5	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1932905171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELEN HANDS ADULT FAMILY HOME LLC

Provider Business Mailing Address
First Line	:	519 LENORA DR
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53090-2701
Country	:	US
Telephone Number	:	414-215-5143
Fax Number	:

Provider Business Practice Location Address
First Line	:	519 LENORA DR
Second Line	:
City	:	WEST BEND
State	:	WI
Zip	:	53090-2701
Country	:	US
Telephone Number	:	414-215-5143
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS BRITTANY S VORTIS
Credential	:
Telephone Number	:	414-215-5143

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	02/19/2025

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