Provider Demographics
NPI:1417699828
Name:EXCEPTIONAL HEALTH NETWORK LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL HEALTH NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-499-7720
Mailing Address - Street 1:8200 W BROWN DEER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-1710
Mailing Address - Country:US
Mailing Address - Phone:414-499-7720
Mailing Address - Fax:414-662-5198
Practice Address - Street 1:8200 W BROWN DEER RD STE 210
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-1710
Practice Address - Country:US
Practice Address - Phone:414-499-7720
Practice Address - Fax:414-662-5198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health