Provider Demographics
NPI:1891142865
Name:HHA OF WISCONSIN, LLC
Entity Type:Organization
Organization Name:HHA OF WISCONSIN, LLC
Other - Org Name:ALMOST FAMILY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHASSIN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:800-489-1307
Mailing Address - Fax:337-233-5764
Practice Address - Street 1:1052 OAK FOREST DR STE 160
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-3703
Practice Address - Country:US
Practice Address - Phone:608-779-0900
Practice Address - Fax:608-779-0903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HHA OF WISCONSIN, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-19
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100061690Medicaid