Healthcare Provider Details

I. General information

NPI: 1023921483
Provider Name (Legal Business Name): LIVING INDEPENDENTLY WITH A VOICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E19745 COUNTY ROAD ND
AUGUSTA WI
54722-5082
US

IV. Provider business mailing address

E19745 COUNTY ROAD ND
AUGUSTA WI
54722-5082
US

V. Phone/Fax

Practice location:
  • Phone: 563-581-8352
  • Fax:
Mailing address:
  • Phone: 563-581-8352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY GLENN WEDGEWORTH
Title or Position: CEO
Credential:
Phone: 563-581-8353