Healthcare Provider Details
I. General information
NPI: 1023698867
Provider Name (Legal Business Name): LINK HOME THERAPY SERVICES OF WISCONSIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2021
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4650 W SPENCER ST
APPLETON WI
54914-9106
US
IV. Provider business mailing address
180 SYLVAN AVE STE 401
ENGLEWOOD CLIFFS NJ
07632-2512
US
V. Phone/Fax
- Phone: 917-855-2114
- Fax:
- Phone: 917-855-2114
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
SAX
Title or Position: DIRECTOR
Credential:
Phone: 917-855-2114