Provider Demographics
NPI:1609192475
Name:BORTSCREATION LLC
Entity Type:Organization
Organization Name:BORTSCREATION LLC
Other - Org Name:SENIOR HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BORTOLAMEOLLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-749-9700
Mailing Address - Street 1:3962 N RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7153
Mailing Address - Country:US
Mailing Address - Phone:920-749-9700
Mailing Address - Fax:920-749-1595
Practice Address - Street 1:3962 N RICHMOND ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7153
Practice Address - Country:US
Practice Address - Phone:920-749-9700
Practice Address - Fax:920-749-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care