Organization
LIVING WELL HOME HEALTH CARE & SUPPORTIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA TAYLOR (OWNER)
(414) 231-3710
Entity
Organization
Contact information
Practice address
6937 W. FOND DU LAC AVE, MIL, WI 53218
(414) 231-3710
(414) 231-3734
Mailing address
P.O. BOX 241003, MILWAUKEE, WI 53224-2633
(414) 231-3710
(414) 231-3734
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067073
—
WI
05
—
1649713033
—
WI
Enumeration date
05/03/2017
Last updated
04/11/2022
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