=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255300299
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING COMPANIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 507 S 5TH ST
-----------------------------------------------------
City | WATERTOWN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53094-4608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-261-8984
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 507 S 5TH ST
-----------------------------------------------------
City | WATERTOWN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53094-4608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MS. JANICE ADELE JOLLIFF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 920-261-8984
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 224747
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------