Provider Demographics
NPI:1518987858
Name:METRO HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:METRO HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-464-4490
Mailing Address - Street 1:6014 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-5553
Mailing Address - Country:US
Mailing Address - Phone:414-464-4490
Mailing Address - Fax:414-464-6114
Practice Address - Street 1:6014 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-5553
Practice Address - Country:US
Practice Address - Phone:414-464-4490
Practice Address - Fax:414-464-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI23OtherWI HOME HEALTH LICENSE
WI41508700Medicaid
WI23OtherWI HOME HEALTH LICENSE