| NPI | 1265040711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVARISTO ANTONIO RODRIGUEZ Administrator 414-422-5317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2022-09-16 |