Provider Demographics
NPI:1619438553
Name:ALLY CARE AGENCY LLC
Entity Type:Organization
Organization Name:ALLY CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EBONI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-330-0630
Mailing Address - Street 1:9730 W BLUEMOUND RD STE 23A
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4463
Mailing Address - Country:US
Mailing Address - Phone:262-330-0630
Mailing Address - Fax:877-852-7448
Practice Address - Street 1:9730 W BLUEMOUND RD
Practice Address - Street 2:SUITE 23A
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:262-330-0630
Practice Address - Fax:877-852-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care