Provider Demographics
NPI:1710491196
Name:AT HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:AT HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:QUIANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-380-1334
Mailing Address - Street 1:7149 W GRANTOSA CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3947
Mailing Address - Country:US
Mailing Address - Phone:414-380-1334
Mailing Address - Fax:
Practice Address - Street 1:7607 W TOWNSEND ST STE 107
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-3974
Practice Address - Country:US
Practice Address - Phone:414-210-5020
Practice Address - Fax:844-270-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health