MEDICARE: KEEP YOUR CROWN

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1982562229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEEP YOUR CROWN

Provider Business Mailing Address
First Line	:	4330 N 63RD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1245
Country	:	US
Telephone Number	:	414-841-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4330 N 63RD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-1245
Country	:	US
Telephone Number	:	414-841-9400
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	ERICA BRADY
Credential	:
Telephone Number	:	414-841-9400

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “KEEP YOUR CROWN ” Practice Location

Language	Start Address	Practice Location

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