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General NPI Number Information
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NPI Number | 1770074080
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Entity Type | Organization
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Legal Business Name | SUNVALE HOMES LLC
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 4714 N 58TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53218
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Country | US
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Telephone | 414-464-2374
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Fax | 414-464-2353
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Provider Business Mailing Address
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Address Line | PO BOX 17
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City | MILWAUKEE
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State | WI
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Zip | 53201-0017
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Country | US
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Telephone | 313-282-4953
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Fax | 414-464-2353
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LUKIE CHRISTIE
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Credential |
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Telephone | 414-539-4855
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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 | 0010101
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0014111
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0015427
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0013058
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0013808
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License Number State | WI
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