Provider Demographics
NPI:1639506488
Name:PREFERRED HOME CARE LLC
Entity Type:Organization
Organization Name:PREFERRED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:MPANJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-469-5883
Mailing Address - Street 1:8700 N 62ND ST
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2810
Mailing Address - Country:US
Mailing Address - Phone:414-469-5883
Mailing Address - Fax:
Practice Address - Street 1:6430 N 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6102
Practice Address - Country:US
Practice Address - Phone:414-469-5883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health