Provider Demographics
NPI:1902370695
Name:HOME CARE ASSISTANCE SERVICES, LLC
Entity Type:Organization
Organization Name:HOME CARE ASSISTANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-568-1051
Mailing Address - Street 1:1001 MADISON AVENUE
Mailing Address - Street 2:SUITE C
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538
Mailing Address - Country:US
Mailing Address - Phone:920-568-1051
Mailing Address - Fax:920-568-1055
Practice Address - Street 1:1001 MADISON AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538
Practice Address - Country:US
Practice Address - Phone:920-568-1051
Practice Address - Fax:920-568-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care