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General NPI Number Information
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NPI Number | 1568845170
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Entity Type | Organization
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Legal Business Name | SKILLED CURATIVE SUPPORT SERVICES
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 1255 N SUNNYSLOPE DR UNIT 203
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-3485
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Country | US
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Telephone | 262-498-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 N SUNNYSLOPE DR UNIT 203
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-3485
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Country | US
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Telephone | 262-498-6449
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Fax |
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Authorized Official
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Title or Position | REGISTERED OCCUPATIONAL THERAPIST
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Name | HEATHER DEBRUIN
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Credential | M.S. OTR/L
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Telephone | 262-498-6449
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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 | 5369
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5799
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 056010205
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License Number State | IL
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