Healthcare Provider Details

I. General information

NPI: 1205605094
Provider Name (Legal Business Name): ABELOVINGTON HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US

IV. Provider business mailing address

1433 N WATER ST STE 400
MILWAUKEE WI
53202-2603
US

V. Phone/Fax

Practice location:
  • Phone: 618-214-2565
  • Fax: 262-299-9819
Mailing address:
  • Phone: 618-214-2565
  • Fax: 262-299-9819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DANITA SPENCER
Title or Position: CEO
Credential:
Phone: 414-491-9080