# NORTH LAKES NURSING HOME HEALTH CARE AGENCY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** North Lakes Nursing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174017339
- **Authorized official:** LISA WOLLER (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (262) 825-3204

## Contact information

- **Practice address:** 225 E FAIRMOUNT AVE, MILWAUKEE, WI 53217
- **Practice address phone:** (414) 967-9355
- **Mailing address:** 225 E FAIRMOUNT AVE, MILWAUKEE, WI 53217-5853

## Taxonomy

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

## Other

- **Enumeration date:** 06/20/2018
- **Last updated:** 06/22/2018