# BW HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124612122
- **Authorized official:** MS. JUANITA C NICKELSON (OWNER)
- **Authorized official phone:** (414) 704-4217

## Contact information

- **Practice address:** 2501 MCKENNA BLVD, MADISON, WI 53711
- **Practice address phone:** (414) 704-4217
- **Mailing address:** 733 STRUCK ST UNIT 45617, MADISON, WI 53744-3660
- **Mailing address phone:** (414) 704-4217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/22/2021
- **Last updated:** 02/22/2021