NPI 1639446172

Professional Home Care Providers

Organisation Preferred Provider Organization Pleasant Prairie, WI

Practice location

Address: 10152 8th Ave, Pleasant Prairie, WI 53158-5413
Phone: (262) 942-8484
Mailing address: 10152 8th Ave, Pleasant Prairie, WI 53158

Authorised official

Name: Anzhela Andreichyk
Title: Lpn
Phone: (262) 942-8484

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 307458-31 (WI)

Other Preferred Provider Organization providers in Wisconsin →

Registry record

NPI: 1639446172
Entity type: Organization
NPI issued: 29 Nov 2011
Record last updated: 7 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.