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General NPI Number Information
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NPI Number | 1942827928
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Entity Type | Organization
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Legal Business Name | SMILING FACES HOME HEALTH LLC
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 222 MIDNIGHT PASS APT 307
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City | VERONA
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State | WI
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Zip | 53593-9484
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Country | US
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Telephone | 608-906-8601
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Fax |
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Provider Business Mailing Address
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Address Line | 222 MIDNIGHT PASS APT 307
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City | VERONA
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State | WI
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Zip | 53593-9484
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Country | US
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Telephone | 608-906-8601
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. FATHIYA MJ ISSA
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Credential | CNA
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Telephone | 608-906-8601
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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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