Provider Demographics
NPI:1740567262
Name:UNITED HOME CARE
Entity Type:Organization
Organization Name:UNITED HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELON
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:STACKHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-433-1867
Mailing Address - Street 1:735 N WATER ST
Mailing Address - Street 2:SUITE 1227
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4100
Mailing Address - Country:US
Mailing Address - Phone:224-433-1867
Mailing Address - Fax:866-418-8779
Practice Address - Street 1:735 N WATER ST
Practice Address - Street 2:SUITE 1227
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4100
Practice Address - Country:US
Practice Address - Phone:224-433-1867
Practice Address - Fax:866-418-8779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care