Healthcare Provider Details

I. General information

NPI: 1255100905
Provider Name (Legal Business Name): ABRILLANCE HOME HEALTHCARE LLC
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

6951 N 60TH ST APT 203
MILWAUKEE WI
53223-5296
US

IV. Provider business mailing address

6951 N 60TH ST APT 203
MILWAUKEE WI
53223-5296
US

V. Phone/Fax

Practice location:
  • Phone: 414-520-9501
  • Fax:
Mailing address:
  • Phone: 414-520-9501
  • Fax:

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CHRISTAIN SPENCER
Title or Position: CEO
Credential:
Phone: 414-520-9501