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General NPI Number Information
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NPI Number | 1467955633
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Entity Type | Organization
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Legal Business Name | MQH HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 6577 N BRAEBURN LN
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City | GLENDALE
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State | WI
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Zip | 53209-3323
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Country | US
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Telephone | 414-206-4365
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Fax | 414-206-0871
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Provider Business Mailing Address
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Address Line | 6577 N BRAEBURN LN
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City | GLENDALE
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State | WI
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Zip | 53209-3323
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Country | US
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Telephone | 414-206-4365
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Fax | 414-206-0871
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Authorized Official
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Title or Position | OWNER
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Name | MS. GERALDINE MARIE RODGERS
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Credential |
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Telephone | 414-206-4365
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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 |
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License Number State | WI
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