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General NPI Number Information
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NPI Number | 1639326176
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Entity Type | Organization
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Legal Business Name | SPRING VALLEY HEALTH CARE SERVICES, INC.
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | W500 STATE ROAD 29
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City | SPRING VALLEY
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State | WI
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Zip | 54767-9031
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Country | US
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Telephone | 715-778-5045
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Fax | 715-778-4516
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Provider Business Mailing Address
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Address Line | W500 STATE ROAD 29
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City | SPRING VALLEY
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State | WI
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Zip | 54767-9031
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Country | US
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Telephone | 715-778-5045
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Fax | 715-778-4516
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MR. KEVIN H LARSON
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Credential | CNHA
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Telephone | 715-778-5545
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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 | 349
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License Number State | WI
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