Provider Demographics
NPI:1639623226
Name:SEDARE HOME CARE LLC
Entity Type:Organization
Organization Name:SEDARE HOME CARE LLC
Other - Org Name:TALEM HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:414-206-2090
Mailing Address - Street 1:3383 N FIVE MILE RD # 168
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-3925
Mailing Address - Country:US
Mailing Address - Phone:414-206-2090
Mailing Address - Fax:
Practice Address - Street 1:10335 W OKLAHOMA AVE STE 204
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4100
Practice Address - Country:US
Practice Address - Phone:414-206-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care