Provider Demographics
NPI:1326811043
Name:WILOU HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:WILOU HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAISE
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:203-401-9918
Mailing Address - Street 1:163 BOSTON POST RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-2840
Mailing Address - Country:US
Mailing Address - Phone:860-986-7744
Mailing Address - Fax:860-321-1515
Practice Address - Street 1:163 BOSTON POST RD STE 2B
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-2840
Practice Address - Country:US
Practice Address - Phone:860-986-7744
Practice Address - Fax:860-321-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care