Provider Demographics
NPI:1083067367
Name:GENERATIONS OF CARE LLC
Entity Type:Organization
Organization Name:GENERATIONS OF CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NOU
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-370-7287
Mailing Address - Street 1:2920 S WEBSTER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1594
Mailing Address - Country:US
Mailing Address - Phone:920-370-7287
Mailing Address - Fax:
Practice Address - Street 1:2920 S WEBSTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1594
Practice Address - Country:US
Practice Address - Phone:920-370-7287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care