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NPI Code Detail

MEDICARE: HIGHLANDER HOME HEALTH CARE, LLC

MEDICARE: HIGHLANDER HOME HEALTH CARE, 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
1251E00000XHome Health AgencyPCA 122WI

Other Identifiers

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

General Provider Information

NPI Number : 1184653867
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLANDER HOME HEALTH CARE, LLC
Provider Business Mailing Address
First Line : 5626 N 91ST ST
Second Line : SUITE 203
City : MILWAUKEE
State : WI
Zip : 53225-2745
Country : US
Telephone Number : 414-461-2331
Fax Number : 414-461-2332
Provider Business Practice Location Address
First Line : 5626 N 91ST ST
Second Line : SUITE 203
City : MILWAUKEE
State : WI
Zip : 53225-2745
Country : US
Telephone Number : 414-461-2331
Fax Number : 414-461-2332
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. RICHARD CHAO VANG
Credential :
Telephone Number : 414-461-2331
Provider Enumeration Date : 07/03/2006
Last Update Date : 04/30/2014

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Directions to “HIGHLANDER HOME HEALTH CARE, LLC ” Practice Location

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