Provider Demographics
NPI:1578296661
Name:MILYFE PERSONAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:MILYFE PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKSTON
Authorized Official - Suffix:
Authorized Official - Credentials:BAS
Authorized Official - Phone:414-239-1540
Mailing Address - Street 1:6150 W FOND DU LAC AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-5600
Mailing Address - Country:US
Mailing Address - Phone:414-930-0072
Mailing Address - Fax:
Practice Address - Street 1:6150 W FOND DU LAC AVE STE 201
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-5600
Practice Address - Country:US
Practice Address - Phone:414-930-0072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable