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General NPI Number Information
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NPI Number | 1013852482
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Entity Type | Organization
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Legal Business Name | KICKAPOO CARES
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 110 N MAIN ST
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City | WESTBY
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State | WI
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Zip | 54667-1106
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Country | US
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Telephone | 608-634-2365
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Fax | 608-634-6388
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Provider Business Mailing Address
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Address Line | 110 N MAIN ST
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City | WESTBY
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State | WI
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Zip | 54667-1106
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Country | US
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Telephone | 608-634-2365
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Fax | 608-634-6388
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | DR. ANTHONY F SHAY
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Credential | ED.D., LPC
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Telephone | 608-634-2365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #3
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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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