Provider Demographics
NPI:1316556293
Name:CARE CONNECTION
Entity Type:Organization
Organization Name:CARE CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-841-5614
Mailing Address - Street 1:12007 W BURLEIGH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3121
Mailing Address - Country:US
Mailing Address - Phone:414-841-5614
Mailing Address - Fax:
Practice Address - Street 1:120 BISHOPS WAY STE 165
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-6249
Practice Address - Country:US
Practice Address - Phone:414-841-5614
Practice Address - Fax:414-240-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care