Provider Demographics
NPI:1952688426
Name:WISCONSIN HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:WISCONSIN HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:TENG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:920-288-0661
Mailing Address - Street 1:840 CHALLENGER DR STE 161
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-8351
Mailing Address - Country:US
Mailing Address - Phone:920-288-0661
Mailing Address - Fax:920-288-0663
Practice Address - Street 1:840 CHALLENGER DR STE 161
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-8351
Practice Address - Country:US
Practice Address - Phone:920-288-0661
Practice Address - Fax:920-288-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health