=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689003436
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERVING HANDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2013
-----------------------------------------------------
Last Update Date | 11/02/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1419 BOULDER COURT
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-808-0564
-----------------------------------------------------
Fax | 715-808-0452
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1419 BOULDER COURT
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-808-0564
-----------------------------------------------------
Fax | 715-808-0452
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | MR. PATRICK PAUL WESTERHAM
-----------------------------------------------------
Credential | LCSW LICSW
-----------------------------------------------------
Telephone | 715-808-0564
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------