Provider Demographics
NPI:1134328032
Name:OCCUCARE SYSTEMS & SOLUTIONS
Entity Type:Organization
Organization Name:OCCUCARE SYSTEMS & SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMELO
Authorized Official - Middle Name:D
Authorized Official - Last Name:TENUTA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:262-657-0222
Mailing Address - Street 1:3915 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-1957
Mailing Address - Country:US
Mailing Address - Phone:262-657-0222
Mailing Address - Fax:262-657-7190
Practice Address - Street 1:3915 30TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-1957
Practice Address - Country:US
Practice Address - Phone:262-657-0222
Practice Address - Fax:262-657-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty