Organization
ESSENTIAL HOME CARE LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAKISHA DILWORTH AM (OWNER/ADMINISTRATOR)
(262) 720-2552
Entity
Organization
Contact information
Practice address
4680 W BRADLEY RD, BROWN DEER, WI 53223-3764
(414) 446-8039
(414) 755-7405
Mailing address
PO BOX 91154, MILWAUKEE, WI 53209-8154
(262) 720-2552
(414) 755-7404
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100159620
—
WI
Enumeration date
07/22/2022
Last updated
12/19/2024
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