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General NPI Number Information
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NPI Number | 1417329608
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Entity Type | Organization
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Legal Business Name | ARBOR LANE CARES, LLC
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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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 |
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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 |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | 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 | 4704302864
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License Number State | WI
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