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General NPI Number Information
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NPI Number | 1578882726
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Entity Type | Organization
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Legal Business Name | EASY LIVING HOME HEALTH CARE AGENCY, INC.
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | W175N11117 STONEWOOD DR STE 203
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City | GERMANTOWN
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State | WI
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Zip | 53022-6506
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Country | US
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Telephone | 414-531-3598
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Fax |
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Provider Business Mailing Address
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Address Line | W175N11117 STONEWOOD DR STE 203
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City | GERMANTOWN
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State | WI
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Zip | 53022-6506
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Country | US
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Telephone | 414-531-3598
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Fax |
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Authorized Official
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Title or Position | CO OWNER
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Name | LAURA BALCERAK
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Credential | COTA
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Telephone | 414-531-3598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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