Healthcare Provider Details

I. General information

NPI: 1396424784
Provider Name (Legal Business Name): ARLACSHA OLIVIA WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 N 33RD ST
MILWAUKEE WI
53208-2303
US

IV. Provider business mailing address

1622 N 33RD ST
MILWAUKEE WI
53208-2303
US

V. Phone/Fax

Practice location:
  • Phone: 414-312-1214
  • Fax:
Mailing address:
  • Phone: 414-312-1214
  • 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 Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: