MEDICARE: ANS PERSONAL CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	100042986	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093181117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANS PERSONAL CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2731 WASHINGTON AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53405-5002
Country	:	US
Telephone Number	:	414-481-9800
Fax Number	:	262-633-8003

Provider Business Practice Location Address
First Line	:	1551 S 108TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-4020
Country	:	US
Telephone Number	:	414-481-9800
Fax Number	:	414-481-9808

Authorized Official
Title or Position	:	CEO
Name	:	MISS KIM ELLIS
Credential	:
Telephone Number	:	414-481-9800

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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