MEDICARE: ENVISION HEALTH CARE

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

General Provider Information

NPI Number	:	1174806376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENVISION HEALTH CARE

Provider Business Mailing Address
First Line	:	500 W SILVER SPRING DR
Second Line	:	SUITE K-200
City	:	GLENDALE
State	:	WI
Zip	:	53217-5051
Country	:	US
Telephone Number	:	414-847-6345
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W SILVER SPRING DR
Second Line	:	SUITE K-200
City	:	GLENDALE
State	:	WI
Zip	:	53217-5051
Country	:	US
Telephone Number	:	414-847-6345
Fax Number	:

Authorized Official
Title or Position	:	RN SUPERVISOR
Name	:	MS. DANA FRINGER
Credential	:	RN
Telephone Number	:	414-847-6345

Provider Enumeration Date	:	09/23/2011
Last Update Date	:	09/23/2011

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Directions to “ENVISION HEALTH CARE ” Practice Location

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