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General NPI Number Information
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NPI Number | 1588189005
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Entity Type | Organization
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Legal Business Name | MELLIE & LILLIAN'S HOME HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 1226 E MORELAND BLVD
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City | WAUKESHA
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State | WI
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Zip | 53186-2553
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Country | US
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Telephone | 262-527-1912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1245
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City | WAUKESHA
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State | WI
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Zip | 53187-1245
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Country | US
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Telephone | 262-527-1912
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. YOLANDA TROTTER
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Credential |
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Telephone | 262-527-1912
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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 |
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