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General NPI Number Information
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NPI Number | 1437228244
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Entity Type | Organization
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Legal Business Name | LS PROFESSIONAL COMFORT HOMES INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 14665 W LISBON RD SUITE 1A
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City | BROOKFIELD
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State | WI
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Zip | 53005-1687
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Country | US
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Telephone | 262-781-0448
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Fax | 262-781-1307
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Provider Business Mailing Address
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Address Line | 4765 N 148TH ST
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City | BROOKFIELD
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State | WI
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Zip | 53005-1566
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Country | US
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Telephone | 262-781-0448
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Fax | 262-781-1307
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LAURA STAMM
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Credential | RN
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Telephone | 262-781-0448
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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 | 1022
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License Number State | WI
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