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General NPI Number Information
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NPI Number | 1851749675
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Entity Type | Organization
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Legal Business Name | ATTENTIVE HOME CARE, INC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 10721 W CAPITOL DR SUITE 224
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City | WAUWATOSA
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State | WI
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Zip | 53222-1210
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Country | US
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Telephone | 414-444-4003
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Fax | 414-444-5003
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Provider Business Mailing Address
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Address Line | 10721 W CAPITOL DR SUITE 224
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City | WAUWATOSA
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State | WI
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Zip | 53222-1210
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Country | US
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Telephone | 414-897-0834
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Fax | 414-897-0839
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Authorized Official
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Title or Position | CLINICAL SERVICES DIRECTOR
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Name | KIM MOORE
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Credential |
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Telephone | 414-444-4003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 100037380
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License Number State | WI
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