Provider Demographics
NPI:1346581782
Name:WHITE'S HOME CARE LLC
Entity Type:Organization
Organization Name:WHITE'S HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LANELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:ICS
Authorized Official - Phone:414-536-7098
Mailing Address - Street 1:6400 W CAPITOL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2156
Mailing Address - Country:US
Mailing Address - Phone:414-536-7098
Mailing Address - Fax:414-536-7106
Practice Address - Street 1:6400 W CAPITOL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2156
Practice Address - Country:US
Practice Address - Phone:414-536-7098
Practice Address - Fax:414-536-7106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIW060837253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care