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General NPI Number Information
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NPI Number | 1053264663
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SENIOR SIDEKICKS BY NURSE VILLA LLC
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 1327 N WRIGHT RD STE 60
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City | JANESVILLE
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State | WI
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Zip | 53546-1524
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Country | US
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Telephone | 608-974-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MYRTLE WAY UNIT 308
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City | JANESVILLE
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State | WI
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Zip | 53545-9142
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Country | US
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Telephone | 608-974-7090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE VILLA
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Credential | RN
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Telephone | 608-974-7090
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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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