| NPI | 1477660132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOUPHALACK KHAMMYVONG Administrator/ Don 414-578-2961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: WI 527256) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-02-10 |