Healthcare Provider Details

I. General information

NPI: 1578489191
Provider Name (Legal Business Name): 547 EAU CLAIRE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 09/23/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 BEVERLY HILLS DR
EAU CLAIRE WI
54701-6727
US

IV. Provider business mailing address

2607 BEVERLY HILLS DR
EAU CLAIRE WI
54701-6727
US

V. Phone/Fax

Practice location:
  • Phone: 715-563-5005
  • Fax:
Mailing address:
  • Phone: 715-563-5005
  • 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. JEREMIAH DOUGLAS PHILLIPS JR.
Title or Position: OWNER
Credential:
Phone: 715-563-5005