# ST MARYS HOME HEALTH CARE OF WISCONSIN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** st marys home health care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225209703
- **Authorized official:** MRS. DOROTHY D EVERETTE HOME CARE (OFFICE MANAGER)
- **Authorized official phone:** (414) 874-1733

## Contact information

- **Practice address:** 4265 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
- **Practice address phone:** (414) 874-1733
- **Practice address fax:** (414) 874-1737
- **Mailing address:** 4265 W FOND DU LAC AVE, MILWAUKEE, WI 53216-3527
- **Mailing address phone:** (414) 874-1733
- **Mailing address fax:** (414) 874-1737

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1079 | WI | Yes |

## Other

- **Enumeration date:** 03/12/2008
- **Last updated:** 03/12/2008