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General NPI Number Information
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NPI Number | 1013300060
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Entity Type | Organization
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Legal Business Name | PAS DE DEUX LLC
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 200 ARBOR LN
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City | GREEN BAY
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State | WI
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Zip | 54301-1604
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Country | US
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Telephone | 920-347-2254
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Fax | 920-347-0338
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Provider Business Mailing Address
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Address Line | 200 ARBOR LN
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City | GREEN BAY
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State | WI
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Zip | 54301-1604
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Country | US
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Telephone | 920-347-2254
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Fax | 920-347-0338
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JEFFREY J HUGUET
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Credential | PARAMEDIC
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Telephone | 920-347-2254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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