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General NPI Number Information
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NPI Number | 1679960694
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Entity Type | Organization
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Legal Business Name | DAVIS AND PADEN HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 3707 W GOOD HOPE RD APT 19
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City | MILWAUKEE
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State | WI
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Zip | 53209-2363
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Country | US
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Telephone | 618-719-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 916 MILWAUKEE AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2146
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Country | US
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Telephone | 618-719-6388
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEZIMON DAVIS
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Credential |
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Telephone | 618-719-6388
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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 | WI
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