PROHEALTH HOME CARE INC. NPI 1356316160

NPI Information

NPI: 1356316160
Provider Name: PROHEALTH HOME CARE, INC.

Other Name: PROHEALTH HOME HOSPICE AND ANGELSGRACE HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 52D0722089

Address:
1020 JAMES DR
STE E
HARTLAND, WI
ZIP 53029
Phone: (262) 928-7444
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PROHEALTH HOME CARE, INC. is a hospice care community based in Hartland, WI. PROHEALTH HOME CARE, INC. NPI is 1356316160. The provider is registered as an organization entity type.
The provider Other Name Is Prohealth Home Hospice And Angelsgrace Hospice.

The provider's business location address is:

1020 JAMES DR
STE E
HARTLAND, WI
ZIP 53029
Phone: (262) 928-7444
Fax: (262) 928-7446

The provider's authorized official is Robert W. Walters .
The authorized official title is Director, Prohealth Home Care, Inc. and has the following contact phone number (262) 928-7887.

The CLIA number assigned to this NPI record is 52D0722089 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2006 and was last updated on 12/20/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		527	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7200001	OTHER	WISCONSIN	UNITED HEALTH CARE
2	43183600	MEDICAID	WISCONSIN
3	521537	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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