Provider Demographics
NPI:1982218426
Name:HOMECARE PAL, LLC
Entity Type:Organization
Organization Name:HOMECARE PAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-234-2121
Mailing Address - Street 1:2916 MARKETPLACE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-5327
Mailing Address - Country:US
Mailing Address - Phone:608-234-2121
Mailing Address - Fax:
Practice Address - Street 1:2916 MARKETPLACE DR STE 209
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-5327
Practice Address - Country:US
Practice Address - Phone:608-234-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health