Rickey Roach is a Home Health Agency based in Milwaukee, WI. Rickey Roach practices in Milwaukee, WI. The NPI Number for Rickey Roach is 1710697818 and holds a License No. 0019066 (Wisconsin).
The current practice location address for Rickey Roach is 2928 N 55Th St, Milwaukee, WI and can be reached out via phone at 414-766-8072.
Location: 2928 N 55Th St, Milwaukee, WI, 53224-9025
Provider Profile Details
NPI Number
1710697818
Provider Name
Rickey Roach
Credential
Provider Entity Type
Individual
Gender
Male
Address
2928 N 55Th St, Milwaukee, WI, 53224-9025
Phone Number
414-766-8072
Fax Number
Provider Enumeration Date
11/29/2022
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87-1298668 | 05 | WI |
Provider Business Practice Location Address Details
Address
2928 N 55Th St
City
State
Zip
53210-1561
Phone Number
414-766-8072
Fax Number
Provider Business Mailing Address Details
Address
2928 N 55Th St
City
State
Zip
53210-1561
Phone Number
414-766-8072
Fax Number
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
License No.
0019066 (Wisconsin)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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