Organization Name: | MY HOME CARE, LLC |
NPI Number: | 1225416175 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KOUA F THAO (ADMINISTRATOR) |
Mailing Address: | 3510 W Burnham St Milwaukee |
State: | WI US |
Postal Code: | 532152096 |
Phone Number: | 4143428300 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2015 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 100014873 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |