Healthcare Provider Details

I. General information

NPI: 1083150809
Provider Name (Legal Business Name): EYE-CARE HOME HEALTH CARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 W KEEFE AVENUE PKWY
MILWAUKEE WI
53216-2773
US

IV. Provider business mailing address

6221 W KEEFE AVENUE PKWY
MILWAUKEE WI
53216-2773
US

V. Phone/Fax

Practice location:
  • Phone: 414-242-4434
  • Fax:
Mailing address:
  • Phone: 414-242-4434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateWI

VIII. Authorized Official

Name: BARBARA J HARRIS
Title or Position: OWNER
Credential: BSW
Phone: 414-242-4434