Healthcare Provider Details

I. General information

NPI: 1679907828
Provider Name (Legal Business Name): LIFE TOUCHES HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 N 76TH ST SUITE A
MILWAUKEE WI
53222-2002
US

IV. Provider business mailing address

4234 N 76TH ST SUITE A
MILWAUKEE WI
53222-2002
US

V. Phone/Fax

Practice location:
  • Phone: 414-465-5433
  • Fax: 866-255-6996
Mailing address:
  • Phone: 414-465-5433
  • Fax: 866-255-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. TYWANA GEORGE
Title or Position: ADMINISTRATOR
Credential:
Phone: 414-465-5433