Provider Demographics
NPI:1598893034
Name:CAREGIVERS LA CROSSE, INC.
Entity Type:Organization
Organization Name:CAREGIVERS LA CROSSE, INC.
Other - Org Name:CAREGIVERS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JET
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:903-561-4455
Mailing Address - Street 1:2020 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8072
Mailing Address - Country:US
Mailing Address - Phone:920-233-2081
Mailing Address - Fax:920-233-8375
Practice Address - Street 1:1802 STATE ROAD 16
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-3011
Practice Address - Country:US
Practice Address - Phone:608-779-0900
Practice Address - Fax:903-779-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1028251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41537100Medicaid
52-7281Medicare ID - Type Unspecified