Organization Name: | SPECIALIZED SERVICES, LLC |
NPI Number: | 1205129277 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CORY DIEHM (OWNER/MEMBER) |
Mailing Address: | 185 E Walnut St Sturgeon Bay |
State: | WI US |
Postal Code: | 542353900 |
Phone Number: | 9207438316 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2011 |
NPI Last Update Date: | 05/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |