Provider Demographics
NPI:1235763699
Name:ICARE PRENATAL.AGENCY INC
Entity Type:Organization
Organization Name:ICARE PRENATAL.AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-659-1973
Mailing Address - Street 1:8018 W CAPITOL DR STE 106
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1951
Mailing Address - Country:US
Mailing Address - Phone:414-659-1973
Mailing Address - Fax:
Practice Address - Street 1:8018 W CAPITOL DR STE 106
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1951
Practice Address - Country:US
Practice Address - Phone:414-659-1973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management