Provider Demographics
NPI:1629569819
Name:SONOMA PERSONAL CARE LLC.
Entity Type:Organization
Organization Name:SONOMA PERSONAL CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRINTHYEST
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-745-8361
Mailing Address - Street 1:5908 N 66TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-1929
Mailing Address - Country:US
Mailing Address - Phone:414-745-8361
Mailing Address - Fax:
Practice Address - Street 1:5908 N 66TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-1929
Practice Address - Country:US
Practice Address - Phone:414-745-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health