Provider Demographics
NPI:1154839504
Name:RENEWED HOPE HOME CARE, LLC
Entity Type:Organization
Organization Name:RENEWED HOPE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YER
Authorized Official - Middle Name:
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-585-9603
Mailing Address - Street 1:5232 W OKLAHOMA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53219-4503
Mailing Address - Country:US
Mailing Address - Phone:414-585-9603
Mailing Address - Fax:414-585-9608
Practice Address - Street 1:5232 W OKLAHOMA AVE STE 105
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-4503
Practice Address - Country:US
Practice Address - Phone:414-585-9603
Practice Address - Fax:414-585-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100062870Medicaid