DESTINATION HOME LLC (NPI# 1124659339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124659339 |
| Entity Type | Organization |
| Organization Name | DESTINATION HOME LLC |
| Practice Address |
S50w30392 Seville Ln Mukwonago WI 53149-8732 |
| Practice Telephone | 2622246754 |
| Mailing Telephone | 2622246754 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | CHERYL BROWN (OWNER) |
| Authorized Official Telephone | 2622246754 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100076054 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | DESTINATION HOME LLC | 26133 Ne 34th St, Redmond, WA 98053 |
| Street Address |
S50W30392 SEVILLE LN |
| City | MUKWONAGO |
| State | WI |
| Zip Code | 53149-8732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669002200 | Cheryl Brown | Technician | S50w30392 Seville Ln, Mukwonago, WI 53149-8732 | 2020-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720433790 | Orthopaedic Associates of Wisconsin Sc | Physical Medicine & Rehabilitation | 1231 S Rochester St Ste 100, Mukwonago, WI 53149 | 2016-04-27 |
| 1952724304 | Therapeutic Healing, LLC | Clinic/Center | S77 W30705 Mosher Dr., Mukwonago, WI 53149 | 2014-01-21 |
| 1659667087 | Joan Maria Stevenson | Occupational Therapist | 111 Aktinson St., Unit 2, Mukwonago, WI 53149 | 2011-06-23 |
| 1770873515 | Kimberly Lynn Schmor | Licensed Practical Nurse | 833 Pinehurst Dr, Mukwonago, WI 53149 | 2011-04-13 |
| 1952619959 | Jennifer Ann Crnkovich | Nurse Practitioner | W307 S7835 Applewood Lane, Mukwonago, WI 53149 | 2010-09-24 |
| 1841460839 | Wendy Schmidt | Occupational Therapist | 1231 S Rochester St Ste 210, Mukwonago, WI 53149 | 2008-03-05 |
| 1659589570 | Pamela Ann Mcwilliams | Dentist | 603 North Rochester St., Mukwonago, WI 53149 | 2007-05-21 |
| 1891823787 | Rosalind J Boyer-cole | Anesthesiology | S86w26640 Rustic View Ln, Mukwonago, WI 53149 | 2007-03-01 |
| 1184777435 | Michael F Connor | Dentist | 603 N Rochester Street, Mukwonago, WI 53149 | 2007-01-19 |
| 1912057159 | Leah Mary Hudson | Occupational Therapist | 103 Apollo Ct, Mukwonago, WI 53149 | 2007-01-11 |
| Find all providers in zip 53149 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669002200 | Cheryl Brown | Technician | S50w30392 Seville Ln, Mukwonago, WI 53149-8732 | 2020-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881291417 | Malaysia Shanae Allen | Technician | 1916 Western Ave, Manitowoc, WI 54220-3838 | 2020-10-06 |
| 1952917585 | Neeny Holdings, Inc. | Technician | 109 Prairie Grass Rd, Oregon, WI 53575-3948 | 2020-09-18 |
| 1265085740 | Best Life Residential | Technician | 4709 Ferris Ave, Madison, WI 53716-1413 | 2019-07-23 |
| 1497315204 | Ravn Williams | Technician | 3532 E Tesch Ave, St Francis, WI 53235-4863 | 2019-06-14 |
| 1780170852 | Patricia Howard | Technician | 2941 Fish Hatchery Rd Apt 209, Fitchburg, WI 53713-3147 | 2018-07-02 |
| 1245749050 | Zehs Home Health Care LLC | Technician | 6001 W Center St Ste 208, Milwaukee, WI 53210-2154 | 2017-09-25 |
| 1245764588 | Pang Vue | Technician | 12714 W Hampton Ave, Ste E, Butler, WI 53007-1640 | 2017-04-13 |
| 1568996049 | Tammie Lynn Du Pree | Technician | 1349 N 37th Pl, Milwaukee, WI 53208-2835 | 2017-04-12 |
| 1184174419 | Cecile Gambrell | Technician | 309 Joellen Dr, Waukesha, WI 53188-4977 | 2016-10-11 |
| 1245600113 | Cinda Kaying Vang | Technician | 2301 Columbus Ln Apt 5, Madison, WI 53704-3581 | 2015-10-04 |
| Find all providers with the same taxonomy | ||||
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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.