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General NPI Number Information
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NPI Number | 1871159103
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Entity Type | Organization
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Legal Business Name | EAU CLAIRE HOME CARE LLC
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 2016 BRACKETT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4629
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Country | US
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Telephone | 715-514-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 2850 COMET CT
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City | EAU CLAIRE
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State | WI
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Zip | 54703-0752
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Country | US
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Telephone | 715-514-3491
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Fax | 715-514-3492
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Authorized Official
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Title or Position | OWNER
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Name | ROCKIE XIONG
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Credential |
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Telephone | 715-514-3491
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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 |
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License Number State |
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