Provider Demographics
NPI:1578882726
Name:EASY LIVING HOME HEALTH CARE AGENCY, INC.
Entity Type:Organization
Organization Name:EASY LIVING HOME HEALTH CARE AGENCY, INC.
Other - Org Name:EASY LIVING THERAPY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALCERAK
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:414-531-3598
Mailing Address - Street 1:W175N11117 STONEWOOD DR STE 203
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-6506
Mailing Address - Country:US
Mailing Address - Phone:414-531-3598
Mailing Address - Fax:
Practice Address - Street 1:W175N11117 STONEWOOD DR STE 203
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-6506
Practice Address - Country:US
Practice Address - Phone:414-531-3598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASY LIVING HOME HEALTH CARE AGENCY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty