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General NPI Number Information
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NPI Number | 1598218562
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Entity Type | Organization
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Legal Business Name | RILEY'S RESIDENTIAL HOME CARE, LLC
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 10111 W. CAPITOL DR
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City | WAUWATOSA
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State | WI
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Zip | 53222
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Country | US
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Telephone | 414-429-4694
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Fax | 877-421-9343
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Provider Business Mailing Address
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Address Line | 10111 W CAPITOL DR STE 7
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City | WAUWATOSA
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State | WI
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Zip | 53222-1335
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Country | US
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Telephone | 414-429-4694
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Fax | 877-421-9343
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Authorized Official
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Title or Position | OWNER/HR MANAGER
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Name | MS. ALANA SHERARD
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Credential |
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Telephone | 414-429-4694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 100053643
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License Number State | WI
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