| Organization Name: | INDIVIDUAL CARE SERVICES LLC |
| NPI Number: | 1841672755 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROY MILBURN PROFITT (MEMBER) |
| Mailing Address: | 133 Haskell St Beaver Dam |
| State: | WI US |
| Postal Code: | 539161609 |
| Phone Number: | 9202966556 |
| Fax Number: | |
| NPI Enumeration Date: | 06/26/2015 |
| NPI Last Update Date: | 06/26/2015 |
| 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 |