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General NPI Number Information
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NPI Number | 1972457489
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Entity Type | Organization
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Legal Business Name | FIRST WATERTOWN CARE LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 1006 LABAREE ST
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City | WATERTOWN
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State | WI
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Zip | 53098-3037
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Country | US
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Telephone | 608-436-7120
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Fax |
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Provider Business Mailing Address
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Address Line | 1006 LABAREE ST
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City | WATERTOWN
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State | WI
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Zip | 53098-3037
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Country | US
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Telephone | 608-436-7120
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | NOMCEBO TREASURE MSOMI-THEOBALD
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Credential |
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Telephone | 608-436-7120
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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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