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General NPI Number Information
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NPI Number | 1316441579
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOME CARE SERVICES
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | N112 W16298 MEQUON RD 127
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City | GERMANTOWN
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State | WI
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Zip | 53022
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Country | US
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Telephone | 414-702-8339
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Fax | 414-435-3152
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Provider Business Mailing Address
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Address Line | N112W16298 MEQUON RD # 127
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City | GERMANTOWN
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State | WI
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Zip | 53022-3306
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Country | US
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Telephone | 414-702-8339
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Fax | 414-435-3152
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PAULA NASH
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Credential |
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Telephone | 414-702-8339
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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 | 100074193
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License Number State | WI
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