Provider Demographics
NPI:1710384037
Name:AMORA HOME CARE
Entity Type:Organization
Organization Name:AMORA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA/ DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-492-0690
Mailing Address - Street 1:217 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-5103
Mailing Address - Country:US
Mailing Address - Phone:920-492-0690
Mailing Address - Fax:
Practice Address - Street 1:217 N MADISON ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-5103
Practice Address - Country:US
Practice Address - Phone:920-492-0690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health