Healthcare Provider Details

I. General information

NPI: 1558546770
Provider Name (Legal Business Name): LAABS HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N 35TH ST
MILWAUKEE WI
53208-3872
US

IV. Provider business mailing address

619 N 35TH ST
MILWAUKEE WI
53208-3872
US

V. Phone/Fax

Practice location:
  • Phone: 414-342-7442
  • Fax:
Mailing address:
  • Phone: 414-342-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number147
License Number StateWI

VIII. Authorized Official

Name: MRS. LINDA MARIE WANGARD
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 414-342-7442