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General NPI Number Information
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NPI Number | 1699092999
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Entity Type | Organization
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Legal Business Name | UNITED EXTENDED HOME HEALTHCARE SERVICES
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 6455 N. FRESNO STREEET
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City | MILWAUKEE
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State | WI
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Zip | 53224
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Country | US
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Telephone | 414-491-6733
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Fax |
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Provider Business Mailing Address
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Address Line | 6455 N. FRESNO STREEET
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City | MILWAUKEE
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State | WI
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Zip | 53224
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Country | US
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Telephone | 414-491-6733
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. AH SONG THAO
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Credential |
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Telephone | 414-491-6733
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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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