| NPI | 1568845170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DEBRUIN Registered Occupational Therapist 262-498-6449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: IL 056010205) |
| Additional Taxonomies | 251E00000X Home Health (Licence: WI 5369) |
| 251E00000X Home Health (Licence: AZ 5799) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |