MEDICARE: ASSURED 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

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	:	1275935959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	4319 N 76TH ST
Second Line	:	SUITE 101
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-2056
Country	:	US
Telephone Number	:	414-462-8908
Fax Number	:	414-462-8909

Provider Business Practice Location Address
First Line	:	4319 N 76TH ST
Second Line	:	SUITE 101
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-2056
Country	:	US
Telephone Number	:	414-462-8908
Fax Number	:	414-462-8909

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BATINA M BROWN
Credential	:
Telephone Number	:	414-462-8908

Provider Enumeration Date	:	09/24/2014
Last Update Date	:	09/24/2014

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Directions to “ASSURED CARE SERVICES, LLC ” Practice Location

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