| NPI | 1508631169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERA R STATEN CEO 262-332-2557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-11-23 |
| Last Update Date | 2023-11-23 |