Provider Demographics
NPI:1437816725
Name:ALBANS LIVING SERVICES LLC
Entity Type:Organization
Organization Name:ALBANS LIVING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TENAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NANGSAR
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:608-358-8042
Mailing Address - Street 1:202 SAINT ALBANS AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-2706
Mailing Address - Country:US
Mailing Address - Phone:608-358-8042
Mailing Address - Fax:
Practice Address - Street 1:202 SAINT ALBANS AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-2706
Practice Address - Country:US
Practice Address - Phone:608-358-8042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health