Healthcare Provider Details

I. General information

NPI: 1548691918
Provider Name (Legal Business Name): THE HOME CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7017 W GREENFIELD AVE
WEST ALLIS WI
53214-4847
US

IV. Provider business mailing address

7017 W GREENFIELD AVE
WEST ALLIS WI
53214-4847
US

V. Phone/Fax

Practice location:
  • Phone: 414-475-7300
  • Fax: 414-475-9119
Mailing address:
  • Phone: 414-475-7300
  • Fax: 414-475-9119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. VIRGINIA LITTLE
Title or Position: OWNER
Credential: LPN
Phone: 414-964-2900