Healthcare Provider Details

I. General information

NPI: 1508965328
Provider Name (Legal Business Name): HOMECARE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 WASHINGTON ST
MANITOWOC WI
54220-5207
US

IV. Provider business mailing address

1004 WASHINGTON ST
MANITOWOC WI
54220-5207
US

V. Phone/Fax

Practice location:
  • Phone: 920-684-7155
  • Fax:
Mailing address:
  • Phone: 920-684-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1
License Number StateWI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LYNN SEIDL-BABCOCK
Title or Position: OWNER
Credential:
Phone: 920-684-7155