Walter'S Second Chance of Milwaukee, LLC.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

WALTER'S SECOND CHANCE OF MILWAUKEE, LLC.

Practice address

3043 N. 29TH Street
Milwaukee, WI 53210

Phone

(414) 388-3815

Fax

(414) 359-2316

NPI assigned

Jan 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary FullerNPI 1740751015

Title

Administrator

Phone

(414) 388-3518

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Fuller

  • Home Health Aide
  • Milwaukee, WI
  • NPI 1740751015
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1922572312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 N. 29TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 N. 29TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53210",
            "telephone_number": "414-388-3815",
            "fax_number": "414-359-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER'S SECOND CHANCE OF MILWAUKEE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-388-3518",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Dennis Walsh, MD
• Susan K. Walsh, LCSW
• Jeffrey Walter, LAT, ATC
• Kathy Walter, LPC
• Kevin D Walter, MD
• Elizabeth Walters, DO
• Jana Susanne Walters, M.A., CCC-SLP
• Jennifer Lee Walters, PA-C
• Robert Walters
• Leslie Waltke

• In Home Supportive Care Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• In Home Supportive Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.