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General NPI Number Information
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NPI Number | 1891347852
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Entity Type | Organization
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Legal Business Name | TSWV CHAO VANG CENTER LLC
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 11010 W HAMPTON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53225-3821
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Country | US
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Telephone | 414-988-2503
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Fax | 414-988-2508
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Provider Business Mailing Address
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Address Line | 11010 W HAMPTON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53225-3821
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Country | US
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Telephone | 414-988-2503
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Fax | 414-988-2508
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RICHARD CHAO VANG
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Credential |
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Telephone | 414-988-2503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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