Provider Demographics
NPI:1922443894
Name:SECOND SPRINGS CARE LLC
Entity Type:Organization
Organization Name:SECOND SPRINGS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:715-861-3474
Mailing Address - Street 1:333 E PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3463
Mailing Address - Country:US
Mailing Address - Phone:715-861-3474
Mailing Address - Fax:715-760-9507
Practice Address - Street 1:5472 178TH ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-6816
Practice Address - Country:US
Practice Address - Phone:715-861-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health