Provider Demographics
NPI:1053291591
Name:NORTHERN HOME CARE GROUP SC
Entity type:Organization
Organization Name:NORTHERN HOME CARE GROUP SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-617-5018
Mailing Address - Street 1:5477 N HOPKINS ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-4637
Mailing Address - Country:US
Mailing Address - Phone:262-617-5018
Mailing Address - Fax:262-617-5018
Practice Address - Street 1:5477 N HOPKINS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-4637
Practice Address - Country:US
Practice Address - Phone:262-617-5018
Practice Address - Fax:262-617-5018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health