LEGACY HOME HEALTHCARE LLC (NPI# 1861852618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861852618 |
| Entity Type | Organization |
| Organization Name | LEGACY HOME HEALTHCARE LLC |
| Practice Address |
6410 W North Ave Wauwatosa WI 53213-2015 |
| Practice Telephone | 4149300464 |
| Practice Fax Number | 4149300493 |
| Mailing Telephone | 4149300464 |
| Mailing Fax Number | 4149300493 |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-21 |
| Authorized Official Name | MR. ONTARIUS BELL (ADMINISTRATOR) |
| Authorized Official Telephone | 4144607971 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100054125 | 05 |
| Street Address |
6410 W NORTH AVE |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53213-2015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932682473 | Tracy A Bolton | Nurse Practitioner | 2626 N 76th St Ste 101, Wauwatosa, WI 53213 | 2018-09-11 |
| 1609309129 | Anupriya Dayal | Student in an Organized Health Care Education/Training Program | 7700 Portland Avenue, #227, Milwaukee, WI 53213 | 2017-04-11 |
| 1407202666 | Michael Lenz | Dentist | 1221 N 62nd Street, 201, Wauwatosa, WI 53213 | 2016-05-06 |
| 1164807889 | Myia Mitchell | Massage Therapist | 6012 W. North Avenue, Milwaukee, WI 53213 | 2015-07-23 |
| 1518369420 | Rachel Rakow | Speech-Language Pathologist | 1009 N 92nd St, Wauwatosa, WI 53213 | 2014-09-23 |
| 1821348335 | Mary Kathryn Maxey | Dietitian, Registered | 1515 Mower Court, Wauwatosa, WI 53213 | 2012-09-12 |
| 1134478506 | Andrea Brooke Moosreiner | Dietitian, Registered | 7220 Milwaukee Ave, Wauwatosa, WI 53213 | 2012-08-31 |
| 1467726075 | Stephanie Miller | Social Worker | 2618 N 61st St, Milwaukee, WI 53213 | 2012-02-28 |
| 1396013447 | Ng Enterprise, Inc. | Home Health | 7635 West Bluemound Road, Suite 1b, Milwaukee, WI 53213 | 2011-12-05 |
| 1184908162 | Lisa Anne Behlmer | Pharmacist | 6600 W. State St, Wauwatosa, WI 53213 | 2011-10-07 |
| Find all providers in zip 53213 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188348 | Derek J Holmes | Home Health | 10111 W Capitol Dr Ste 8, Wauwatosa, WI 53222-1335 | 2020-06-08 |
| 1912538679 | Premier Personal Care Agency LLC | Home Health | 10520 W Bluemound Rd Ste 105, Suite #105, Wauwatosa, WI 53226-4484 | 2020-01-31 |
| 1346881455 | Blessit Hands Personal Care Agency | Home Health | 7332 W State St # 2, Wauwatosa, WI 53213-2766 | 2019-10-01 |
| 1023582897 | Devoted Personal Care, LLC | Home Health | 9730 W Bluemound Rd Ste 4, Wauwatosa, WI 53226-4463 | 2019-01-15 |
| 1306347158 | Profound Home Health Care | Home Health | 12201 W Burleigh St Ste 10, Wauwatosa, WI 53222-3102 | 2018-02-27 |
| 1730699489 | Living Insight Supportive Services LLC | Home Health | 12201 W North Ave Ste 102b, Wauwatosa, WI 53226-2061 | 2017-10-09 |
| 1801310800 | Divine Pathways | Home Health | 10111 W Capitol Dr Ste 4, Wauwatosa, WI 53222-1335 | 2017-08-01 |
| 1588190185 | Living Well Home Health Care | Home Health | 7251 W North Ave Ste 10, Wauwatosa, WI 53213-1851 | 2017-05-03 |
| 1528420247 | Compassionate Personal Care Services,llc | Home Health | 2645 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-1304 | 2016-03-22 |
| 1912371360 | Vanguard Home Health Services LLC | Home Health | 1033 N Mayfair Rd Ste 300, Wauwatosa, WI 53226-3442 | 2015-11-23 |
| Find all providers in WAUWATOSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.