Provider Demographics
NPI:1568845170
Name:SKILLED CURATIVE SUPPORT SERVICES
Entity Type:Organization
Organization Name:SKILLED CURATIVE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBRUIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:262-498-6449
Mailing Address - Street 1:1255 N SUNNYSLOPE DR
Mailing Address - Street 2:UNIT 203
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-3485
Mailing Address - Country:US
Mailing Address - Phone:262-498-6449
Mailing Address - Fax:
Practice Address - Street 1:1255 N SUNNYSLOPE DR
Practice Address - Street 2:UNIT 203
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-3485
Practice Address - Country:US
Practice Address - Phone:262-498-6449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010205251E00000X
WI5369251E00000X
AZ5799251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health